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Management of diabetic hypertensives.
MedLine Citation:
PMID:  22145142     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP) reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives.
Authors:
Jai Ganesh; Vijay Viswanathan
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian journal of endocrinology and metabolism     Volume:  15 Suppl 4     ISSN:  2230-9500     ISO Abbreviation:  Indian J Endocrinol Metab     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-12-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101555690     Medline TA:  Indian J Endocrinol Metab     Country:  India    
Other Details:
Languages:  eng     Pagination:  S374-9     Citation Subset:  -    
Affiliation:
Department of Diabetology, M.V. Hospital for Diabetes, Prof. M. Viswanathan Diabetes Research Centre, WHO Collaborating Centre for Research, Education and Training in Diabetes, No.4, West Mada Church Street, Royapuram, Chennai, India.
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