Via practica 4/2011

Arterial hypertension and diabetes mellitus – view of diabetologist

Diabetes mellitus and hypertension are often occurring in combination. Prevalence of arterial hypertension in type 2 diabetics range from 20 to 60 % and is 1.5 to 3 times more common in diabetics than in non-diabetics of the same age, also frequency of diabetes is higher in hypertension population than in normotonic individuals. Arterial hypertension is one of the most important risk factors for the occurrence of macrovascular (cardiovascular and cerebrovascular) and microvascular complications (retinopathy and nephropathy). Management of hypertension is considered a critical aspect of comprehensive care for diabetes and leads to significant reduction of the above complications. Based on current knowledge in clinical practice it seems appropriate to recommend for diabetic patients with hypertension reduce SBP/DBP 130 – 139/80 – 85 mmHg to values as close as possible to lower values in that range. To achieve effective blood pressure lowering in diabetic patients is usually required combined antihypertensive therapy; all major classes of antihypertensive agents provide protection against macrovascular and microvascular complications. In chronic antihypertensive therapy in patients with high risk of developing diabetes is needed to take into account the selection of antihypertensive treatment with the lowest risk of its development.

Keywords: arterial hypertension, diabetes mellitus, UKPDS, ADDVANCE, ACCORD, ONTARGET, INVEST, SPRINT