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Hypertension in diabetic patients. An overview of interventional studies to preserve renal function
1Department of Medicine, University of Texas Health Science Center, San Antonio.
Abstract:
The combination of diabetes mellitus and hypertension increases the chances for progressive renal disorders and ultimately renal failure. Both animal and human studies have investigated this progression, which does not take place in all diabetic patients, but which does inevitably occur in diabetic patients with hypertension or microalbuminuria. In these patients the control of arterial pressure is critical to the preservation of renal function. Certain antihypertensive agents, notably angiotensin converting enzyme inhibitors, verapamil, and diltiazem, seem to combine the required renal and vascular effects most beneficially. This article reviews the research completed so far into these effects. However, long-term studies are needed to consolidate these findings.
Insights
Diabetes and hypertension accelerate kidney disease, especially in patients with microalbuminuria. Controlling blood pressure with specific antihypertensives is crucial for preserving kidney function, though long-term studies are needed.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Diabetes mellitus and hypertension are leading causes of progressive renal disorders and kidney failure.
- This progression is particularly evident in diabetic patients with coexisting hypertension or microalbuminuria.
- Arterial pressure control is paramount for preserving renal function in these high-risk individuals.
Purpose of the Study:
- To review existing research on the renal and vascular effects of antihypertensive agents in diabetic patients.
- To identify agents that offer beneficial effects for preserving kidney function.
Main Methods:
- Review of animal and human studies investigating the progression of renal disorders in diabetic patients.
- Analysis of the efficacy of specific antihypertensive agents, including ACE inhibitors, verapamil, and diltiazem.
Main Results:
- Certain antihypertensive agents, specifically angiotensin converting enzyme inhibitors, verapamil, and diltiazem, demonstrate beneficial renal and vascular effects.
- These agents appear most effective in managing arterial pressure to preserve renal function.
Conclusions:
- Effective arterial pressure management is critical for preventing renal deterioration in diabetic patients with hypertension or microalbuminuria.
- Further long-term studies are required to confirm the sustained benefits of these antihypertensive agents.