Antihypertensive medication in type 2 diabetics

Česká verzia

Authors: R. Cífková ^1,2,3
Authors place of work: Centrum kardiovaskulární prevence, 1. lékařská fakulta, Univerzita Karlova v Praze a Thomayerova nemocnice, vedoucí prof. MUDr. Renata Cífková, CSc. ¹; II. interní klinika – klinika kardiologie a angiologie, 1. lékařská fakulta, Univerzita Karlova v Praze a Všeobecná fakultní nemocnice v Praze, přednosta prof. MUDr. Aleš Linhart, DrSc. ²; Mezinárodní centrum klinického výzkumu, Brno, mezinárodní koordinátor prof. Francisco Lopez-Jimenez, M. D. ³
Published in the journal: Forum Diab 2013; 2(2): 68-73
Category: Topic

Summary

A key component of diabetes management is a reduction in blood pressure (BP). Antihypertensive medication should be initiated in all diabetics with BP ≥ 140/90 mm Hg. In diabetic patients with high normal BP (130–139/85–89 mm Hg), antihypertensive therapy can be recommended only in those with microalbuminuria. Based on data emerging from the latest clinical trials, the systolic BP goal should be 130–139 mm Hg, if possible, closer to the lower limit of this range. In cases where lifestyle modifications have failed to achieve BP goals, drug treatment in indicated. To achieve BP goals, most diabetics require a combination of antihypertensive drugs which should include an ACE inhibitor or an angiotensin receptor blocker. Comprehensive BP management includes aggressive modification of the other risk factors, in particular lipids. Low-dose aspirin is currently not recommended in diabetics without overt cardiovascular disease.

Key words:
ACE inhibitors – angiotensin receptor blockers – antiplatelet therapy – goal blood pressure – microalbuminuria – nephroprotection –lipid-lowering drugs

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