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Hypertension.

P L Drury

    Bailliere'S Clinical Endocrinology and Metabolism
    |May 1, 1988
    PubMed
    Summary
    This summary is machine-generated.

    Hypertension management in non-insulin-dependent diabetes mellitus (NIDDM) is crucial. While benefits are likely, specific data are lacking, and other risk factors like smoking require attention.

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    Area of Science:

    • Cardiology
    • Endocrinology
    • Public Health

    Background:

    • Hypertension is a significant risk factor for mortality and morbidity in patients with non-insulin-dependent diabetes mellitus (NIDDM).
    • Yearly blood pressure (BP) measurement is standard practice for NIDDM patients.
    • The precise benefits of antihypertensive therapy in NIDDM remain under investigation.

    Purpose of the Study:

    • To review the current understanding of hypertension management in NIDDM.
    • To discuss the evidence for and against specific treatment thresholds and drug choices.
    • To emphasize the importance of considering other cardiovascular risk factors.

    Main Methods:

    • Literature review and synthesis of existing studies and guidelines.
    • Analysis of data regarding cardiovascular outcomes in diabetic and non-diabetic populations.

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  • Consideration of risk-benefit analysis for antihypertensive interventions.

    • Main Results:

    • Evidence suggests potential benefits of antihypertensive therapy in NIDDM, particularly for cerebrovascular outcomes at higher diastolic pressures (>105 mm Hg).
    • No conclusive evidence shows reduced coronary artery disease mortality in NIDDM patients with hypertension.
    • Smoking cessation offers greater mortality risk reduction than antihypertensive therapy for most smokers.

    Conclusions:

    • Treatment thresholds for hypertension in NIDDM without nephropathy may not differ from non-diabetic individuals.
    • Other risk factors, including hyperlipidemia and smoking, are critical and may warrant more aggressive management.
    • Individualized antihypertensive therapy selection is essential, considering patient-specific factors and quality of life.