Management of hypertension in patients with type 2 diabetes mellitus: Guidelines based on current evidence

Norman M Kaplan

Research output: Contribution to journalReview article

63 Scopus citations

Abstract

Hypertension and diabetes are becoming increasingly common. Most patients with both disorders have a markedly worsened risk for premature microvascular and macrovascular complications. The appropriate management of the hypertension seen in almost 70% of patients with type 2 diabetes mellitus remains controversial. However, over the past few years, many randomized, controlled trials have provided guidance for more effective therapy. These trials have established the need for a lower goal blood pressure (<130/80 mm Hg) than has previously been recommended. In addition, they have proven the efficacy of drugs from three major classes of antihypertensive agents; however, comparative trials have failed to show definite superiority of any particular class in either lowering blood pressure or reducing cardiovascular morbidity and mortality. To achieve therapy goals, multiple antihypertensive drugs are usually needed. On the basis of their apparent superiority in slowing diabetic nephropathy, angiotensin-converting enzyme inhibitors should probably be the first choice. Second and third choices should be a long-acting diuretic and a calcium-channel blocker or a β-blocker, respectively. Attention should also be directed toward nonpharmacologic and pharmacologic control of hyperglycemia and dyslipidemia.

Original languageEnglish (US)
Pages (from-to)1079-1083
Number of pages5
JournalAnnals of internal medicine
Volume135
Issue number12
DOIs
StatePublished - Dec 18 2001

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ASJC Scopus subject areas

  • Internal Medicine

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