Treatment of Hypertension in Patients with Diabetes Mellitus: a Contemporary Approach

The association between type 2 diabetes and anhedonic subtype of major depression in hypertensive individuals

“…Indeed, given the negative impact of the co-occurrence of type 2 diabetes and hypertension on glycaemic control, it is essential to respect the guidelines for the combined treatment of type 2 diabetes and hypertension in order to allow optimal glycaemic control in individuals with hypertension and type 2 diabetes. [44][45][46][47] Regarding the treatment of type 2 diabetes in hypertensive individuals, it is currently recommended to implement lifestyle modifications alone or combined with pharmacological treatment (oral glucose-lowering drugs and/or insulin therapy) depending on the initial severity of type 2 diabetes, the objective of glycaemic control and potential comorbid conditions. 44,45 On the other hand, regarding the treatment of hypertension in type 2 diabetics, the establishment of lifestyle modifications combined with antihypertensive therapy is currently recommended in order to allow optimal blood pressure control (< 130/80 mm Hg) in type 2 diabetics with hypertension.…”

“…44,45 On the other hand, regarding the treatment of hypertension in type 2 diabetics, the establishment of lifestyle modifications combined with antihypertensive therapy is currently recommended in order to allow optimal blood pressure control (< 130/80 mm Hg) in type 2 diabetics with hypertension. 46,47 However, in this particular subpopulation, the use alone or in combination of antihypertensive drugs with a demonstrated positive impact on the reduction of cardiovascular mortality (angiotensin-converting-enzyme inhibitors, angiotensin receptor blockers, thiazide-like diuretics and dihydropyridine calcium channel blockers) should be preferred based on the initial severity of hypertension, the goal of blood pressure control and potential comorbid conditions. 46,47 Thus, given the potential positive effect of therapies targeting anhedonia on glycaemic control, the implementation of these therapies targeting anhedonia in addition to an adequate combined treatment of type 2 diabetes and hypertension could be a promising therapeutic option to potentiate conventional glycaemic control strategies in anhedonic major depressed hypertensive individuals with type 2 diabetes.…”

“…However, despite this potential positive effect on glycaemic control of therapies targeting anhedonia, these therapeutic strategies should only be considered in addition to adequate combined treatment of type 2 diabetes and hypertension in anhedonic major depressed hypertensive individuals with type 2 diabetes. Indeed, given the negative impact of the co‐occurrence of type 2 diabetes and hypertension on glycaemic control, it is essential to respect the guidelines for the combined treatment of type 2 diabetes and hypertension in order to allow optimal glycaemic control in individuals with hypertension and type 2 diabetes 44–47 . Regarding the treatment of type 2 diabetes in hypertensive individuals, it is currently recommended to implement lifestyle modifications alone or combined with pharmacological treatment (oral glucose‐lowering drugs and/or insulin therapy) depending on the initial severity of type 2 diabetes, the objective of glycaemic control and potential comorbid conditions 44,45 .…”

“…Regarding the treatment of type 2 diabetes in hypertensive individuals, it is currently recommended to implement lifestyle modifications alone or combined with pharmacological treatment (oral glucose‐lowering drugs and/or insulin therapy) depending on the initial severity of type 2 diabetes, the objective of glycaemic control and potential comorbid conditions 44,45 . On the other hand, regarding the treatment of hypertension in type 2 diabetics, the establishment of lifestyle modifications combined with antihypertensive therapy is currently recommended in order to allow optimal blood pressure control (< 130/80 mm Hg) in type 2 diabetics with hypertension 46,47 . However, in this particular subpopulation, the use alone or in combination of antihypertensive drugs with a demonstrated positive impact on the reduction of cardiovascular mortality (angiotensin‐converting‐enzyme inhibitors, angiotensin receptor blockers, thiazide‐like diuretics and dihydropyridine calcium channel blockers) should be preferred based on the initial severity of hypertension, the goal of blood pressure control and potential comorbid conditions 46,47 .…”

Association of pulse pressure with all‐cause mortality in older Japanese patients with type 2 diabetes mellitus: A observational cohort study

“…In addition, a number of epidemiologic studies have reported that the combination of diabetes and hypertension increases the risk of developing cardiovascular disease (CVD), thereby increasing mortality from coronary artery disease, stroke, and other causes (Beddhu et al, 2018; Buckley et al, 2018; Margolis et al, 2014; Stamler et al, 1993). Therefore, many studies have been conducted to identify optimal blood pressure levels for diabetic patients (Alencherry & Laffin, 2021; Arguedas et al, 2013; Emdin et al, 2015; Ueki et al, 2017; Vijan, 2013). Based on these previous findings, the Japanese Society of Hypertension published recommendations in their 2019 hypertension treatment guidelines to maintain a systolic blood pressure (SBP) of less than 130 mmHg and a diastolic blood pressure (DBP) of less than 80 mmHg in the examination room among patients with diabetes (Umemura et al, 2019).…”