Managing Hypertension in Patients with Diabetes

摘要: Cardiovascular disease remains the leading cause of death in industrialized nations. Type 2 diabetes confers cardiovascular risk comparable to a previous myocardial infarction, and is most common chronic kidney disease. Diabetes hypertension account for 2/3 [1]. Over 75% adults with are hypertensive, or being treated hypertensive medications [2] In patients type 1 diabetes, presence signals significant damage whereas usually present at time diagnosis [2]. On other hand, many treatments, specifically diuretics, worsen glucose control; overall implications this as yet unclear Because singular resulting from combination hypertension, effort has been expended improve patient outcome. While several recent excellent reviews address different aspects issue [1-3], we will evaluate management particularly perspective managing metabolic syndrome. We effects agents used blood pressure control, consider specific patient-related issues, discuss shortcomings trials, possible future directions genetic analyses. There over 65 million hypertensives United States [4]. Unfortunately, pharmacological treatment these individuals had less than predicted benefit on coronary heart (CHD) mortality [5-7]. For years, It postulated that some antihypertensives might have untoward negate benefits blood-pressure lowering [5, 8]. This may be true syndrome, constellation anthropometric abnormalities includes central obesity, elevated levels fasting triglycerides, low concentrations high-density lipoprotein cholesterol (HDL-C), insulin resistance which associated increased morbidity [9-11]. Of five diagnostic criteria obesity frequently [12, 13]. Why increasingly important US? The prevalence doubled US past 20 years [14]; number extremely obese BMI >35