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Hypertension in diabetes mellitus
1Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, USA.
Summary
Early hypertension detection and treatment are crucial for diabetic patients. Angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and alpha-adrenergic blockers are recommended initial antihypertensive drugs for better metabolic profiles.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Hypertension significantly contributes to morbidity and mortality in diabetic individuals.
- Diabetic nephropathy progression can be slowed by antihypertensive treatment.
- Lack of prospective studies on antihypertensive regimens' effects on cardiovascular events in diabetics.
Purpose of the Study:
- To review the role of antihypertensive treatment in diabetic patients.
- To discuss the impact of antihypertensive drugs on metabolic profiles and insulin action.
- To recommend initial antihypertensive drug choices for diabetic patients.
Main Methods:
- Review of existing literature on hypertension in diabetes.
- Analysis of the effects of different antihypertensive drug classes on metabolic parameters.
- Consideration of insulin resistance and hyperinsulinemia in drug selection.
Main Results:
- Antihypertensive therapy is vital for managing diabetic complications.
- Glycemic control and lipid profile are key factors in antihypertensive drug selection.
- ACE inhibitors, calcium channel blockers, and alpha-adrenergic blockers show favorable metabolic profiles.
Conclusions:
- Early hypertension management is essential in diabetes.
- ACE inhibitors, calcium channel blockers, and alpha-adrenergic blockers are preferred initial antihypertensive agents for diabetics.
- Consideration of metabolic effects is crucial when selecting antihypertensive drugs for diabetic patients.