Management of Hypertension in Diabetes

Abstract

In Brief Untreated or poorly controlled hypertension can significantly accelerate the development and progression of both the micro- and macrovascular complications of diabetes. Aggressive blood pressure control improves patient outcomes and reduces health care costs. Unfortunately, nearly two-thirds of people with diabetes do not have blood pressure readings within the target range. Effective antihypertensive regimens maximize nonpharmacological therapies, minimize adverse effects on glucose control, lessen the risk of medication-related side-effects, and provide adequate cardiac and renal protection.

Cost comparison of drug–drug and drug–condition interactions in patients with painful diabetic peripheral neuropathy treated with pregabalin versus duloxetine

“…Given that painful DPN is a microvascular complication of diabetes, and both hypertension and renal disease are comorbid conditions in diabetes, the relatively high rate of these DCIs was also not unexpected. 29 The presence of potential duloxetine DDIs and DCIs was associated with significantly increased health care costs in patients taking duloxetine, while the presence of potential pregabalin DDIs and DCIs was not significantly associated with health care costs in pregabalin users. Furthermore, health care costs of duloxetine users with potential duloxetine DDIs and DCIs were significantly higher than those of pregabalin users with potential pregabalin DDIs and DCIs.…”

Trends in blood pressure control and treatment among type 2 diabetes with comorbid hypertension in the United States: 1988–2004

“…Uncontrolled hypertension in diabetic patients is an important health problem, but BP in diabetic patients can be inadequately controlled due to patient, clinician, and disease factors [41,42]. Patient factors such as noncompliance with therapy, increased susceptibility to hypertension due to advanced age, lack of awareness about diagnosis, and adverse events or restricted access to healthcare can contribute to poor control of BP.…”

Choice of ACE inhibitor combinations in hypertensive patients with type 2 diabetes: update after recent clinical trials

“…At the time of diagnosis, about 50% of type 2 diabetics are also hypertensives. This percentage increases even more in the presence of micro- or macroalbuminuria 3. Microalbuminuria (urinary albumin excretion of 20 to 200 μg/min or 30 to 299 mg/24 hours), which often heralds the onset of diabetic nephropathy, independently predicts cardiovascular morbidity and mortality in diabetic patients 4–6…”