Pharmacotherapy of hypertension in patients with diabetes mellitus.

摘要: The co-existence of hypertension and diabetes dramatically synergistically increases the risk microvascular macrovascular complications. Overwhelming evidence supports aggressive treatment in diabetic patients. However, only a small percentage hypertensive patients reach their goal blood pressure (BP) < 130/80 mmHg. Tight BP control is not cost-effective but also more rewarding than glycaemic control. optimal diabetics should be In subjects with renal insufficiency, lowered to 125/75 mmHg delay progression failure. choice an antihypertensive agent based on proven effects morbidity mortality rather surrogate parameters such as lipid or glucose. Limited data suggests that angiotensin converting enzyme inhibitor (ACEI) choice, especially those proteinuria insufficiency. beta-blockers (betaBs) can first-line coronary heart disease, while thiazide diuretics (TD) calcium-channel blockers (CCBs) are second-line drugs. Angiotensin II-receptor (ARBs) may effective ACEIs hypertension. alpha-adrenergic antagonists (AAAs) avoided. Most require one BP. There no support combination regimen over others; nevertheless, ACEI TD betaB most regimens compared other combinations.