Vaskulárna medicína 2/2013

Arterial hypertension in diabetic patients

Arterial hypertension and as well as diabetes mellitus alone represent diseases with increased risk of cardiovascular diseases. The presence of both conditions increases the risk 2-4 times and therefore it is often proclaimed as lethal duo. There is evidence based medicine prefering the need of strict blood pressure control. To manage hypertension in patients with the diagnose diabetes mellitus it is necessary to focus on the interference of antihypertensive agents with metabolic control, insulin resistance, lipid metabolism, mineral and fluid balance. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are prefered in hypertension therapy in diabetic patients with nephropathy. There is mostly the need of using combination of various antihypertensive agents to reach the blood pressure target. Recent observational studies support the view that very strickt blood pressure control does not present significant benefit versus the standard therapy as for the development of macro- and microvascular complications.

Keywords: arterial hypertension, diabetes mellitus, cardiovascular risk, nephropathy.