Management of arterial hypertension in persons with type 2 diabetes mellitus

Česká verzia

Authors: Udovít Gašpar ^1,2; Slavomíra Filipová ³
Authors place of work: I. interná klinika LF UK a UN Bratislava ¹; Inštitút fyzioterapie, balneológie a liečebnej rehabilitácie (Piešťany) Univerzity sv. Cyrila a Metoda v Trnave ²; Klinika kardiológie a angiológie LF SZU a NÚSCH, Bratislava ³
Published in the journal: Diab Obez 2019; 19(38): 110-114
Category: Reviews

Summary

Diabetes mellitus and arterial hypertension frequently coexist. Effective treatment of arterial hypertension in diabetics significantly improves their cardiovascular prognosis. Different blood pressure targets have been formulated in recent years, and now following the 2018 ESC/ESH Guidelines for Management of Arterial Hypertension, lowering blood pressure to below 130/80 mm Hg, respectively 130–139/70–79 mm Hg in the age group over 65 years, provides optimal cardiovascular protection. Systolic blood pressure should not to be lowered below 120 mmHg and diastolic BP below 70 mmHg. For initial treatment RAS blockers, calcium channel blockers and diuretics, especially in fixed combinations, are the drug of choice. Orthostatic hypotension, as well as nocturnal hypertension, deserve special diagnostic attention in diabetic hypertensive subjects.

Keywords:

arterial hypertension – diabetes mellitus – management – metabolic syndrome – Prognosis – treatment

Zdroje

Zidek W. Arterielle Hypertonie bei Menschen mit Diabetes. Diabetologie 2019; 15(1): 55–64.
Whelton PK, Carey RM, Aronow WS et al. 2017 ACC / AHA /AAPA / ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive summary: A report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 71 (19): 2199–2269. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2017.11.005>. Erratum in Correction. [J Am Coll Cardiol 2018]
Wing LM, Reid CM, Ryan P el al. Second Australian National Blood Pressure Study (ANBP2). Australian Comparative Outcome Trial of ACE inhibitor- and diuretic-based treatment of hypertension in the elderly. Management Committee on behalf of the High Blood Pressure Research Council of Australia. Clin Exp Hypertens 1997; 19(5–6): 779–791. Dostupné z DOI: <http://dx.doi.org/10.3109/10641969709083186>.
Banegas JR, Ruilope LM, dela Sierra A et al. Relationship between clinic and ambulatory blood-pressure measurements and mortality. N Engl J Med 2018; 378(16): 1509–1520. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1712231>.
Bӧhm M, Schumacher H, Teo KK et al. Cardiovascular outcomes and achieved blood pressure in patients with and without diabetes at high cardiovascular risk. Eur Heart J 2019; 40(25): 2032–2043. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehz149>.
Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal treatment (HOT) randomised trial. Lancet 1998; 351 (9118): 1755–1762. Dostupné z DOI: <http://dx.doi.org/10.1016/s0140–6736(98)04311–6>.
Leal J, Hayes AJ, Gray AM et al. Temporal validation of the UKPDS outcomes model using 10-year posttrial monitoring data. Diabetes Care 2013; 36(6): 1541–1546. Dostupné z DOI: <http://dx.doi.org/10.2337/dc12–1120>.
Williams B, Mancia G, Spiering W et al. 2018 ESC/ESH Guidelines for Management of Arterial Hypertension. Eur Heart J 2018; 39(33): 3021–3104. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehy339>.
Filipová S, Gašpar Ľ, Vachulová A et al. Komentár k 2018 ESC/ESH Odporúčaniam manažmentu artériovej hypertenzie. Cardiology Lett 2018; 27(6): 282–288.
Wang Y, Qiao S, Han DW et al. Telmisartan improves insulin resistance. A meta-analysis. Am J Therapeut 2018; 25(6): e642-e651. Dostupné z DOI: <http://dx.doi.org/10.1097/MJT.0000000000000733>.
Yusuf S, Sleight P, Dagenais G et al. [Heart Outcomes Prevention Evaluation Study Investigators]. Effects of an angiotensin-converting-enzyme inhibitor Ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342(3): 145–153. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM200001203420301>. Erratum in 2000; 342(18): 1376. N Engl J Med 2000; 342(10): 748.
van Vark LC, Bertrand M, Akkerhuis M et al. Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of renin-angiotensin-aldosterone system inhibitors involving 158 998 patients. Eur Heart J 2012; 33(16): 2088–2097. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehs075>.
Steensma C, Loukine L, Orpana H et al. Comparing life expectancy and health-adjusted life expectancy by body mass index category in adult Canadians: a descriptive study. Popul Health Metr 2013; 11(1): 21. Dostupné z DOI: <http://dx.doi.org/10.1186/1478–7954–11–21>.
Engeli S, Böhnke J, Gorzelniak K et al. Weight loss and the Renin-Angiotensin – Aldosterone System. Hypertension 2005; 45(3): 356–362. Dostupné z DOI: <http://dx.doi.org/10.1161/01.HYP.0000154361.47683.d3>.
Gavorník P, Dukát A, Gašpar Ľ et al. Komplexná starostlivosť o diabetikov s končatinovocievnou artériovou chorobou. Forum Diab 2018; 7(1): 40–46.
Mancia G, Cannon CP, Tikkanen I et al. Impact of empagliflozin on blood pressure in patients with type 2 diabetes mellitus and hypertension by backround antihypertensive medication. Hypertension 2016; 68(6): 1355–1364. Dostupné z DOI: <http://dx.doi.org/10.1161/HYPERTENSIONAHA.116.07703>.