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Diabetes and arterial hypertension.

P L Drury

    Diabetologia
    |January 1, 1983
    PubMed
    Summary

    Hypertension management in diabetes is complex. While diuretics and beta-blockers are initial choices, only treating diabetic nephropathy shows clear evidence of slowing disease progression.

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    Area of Science:

    • Endocrinology
    • Nephrology
    • Cardiology

    Background:

    • Hypertension is a significant concern in diabetic populations, impacting both Type 1 and Type 2 diabetes.
    • The relationship between hypertension and obesity is notable in Type 2 diabetes, particularly in elderly patients.

    Purpose of the Study:

    • To discuss the epidemiology, pathogenesis, significance, and management of hypertension in diabetic individuals.
    • To explore the association between hypertension and microvascular/macrovascular complications in diabetes.

    Main Methods:

    • Review of existing literature on hypertension in diabetic subjects.
    • Exploration of potential etiological factors including sodium, insulin, renin-angiotensin system, catecholamines, and physical factors.

    Main Results:

    • In Type 1 diabetes, diastolic hypertension correlates with diabetic nephropathy and persistent proteinuria.
    • Obesity largely explains increased hypertension prevalence in Type 2 diabetes; elderly patients may show excess systolic hypertension.
    • Hypertension in diabetics is linked to increased microvascular and macrovascular complications, though causality is uncertain.

    Conclusions:

    • Diuretics and beta-blockers are suggested as initial antihypertensive agents for diabetic patients, acknowledging limitations.
    • Antihypertensive treatment demonstrates reasonable evidence for slowing diabetic nephropathy progression.

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