Treatment of hypertension in diabetes mellitus

Česká verzia

Authors: Jiří Widimský Jr
Authors place of work: III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in the journal: Vnitř Lék 2015; 61(4): 335-337
Category: Reviews

Summary

Hypertension and diabetes mellitus (DM) are common diseases. Prevalence of hypertension in DM type II is 70–80 %. Goal blood pressure (BP) is around 130/80 mm Hg. RAS blockers (ACE inhibitors or AT₁ blockers) are considered as the drugs of choice because of the decrease of cardiovascular risk and prevention of nephropathy. Combination antihypertensive therapy is needed in 80–90 % of pts. Combination of RAS blocker and calcium channel blocker is clinically useful. Diuretics should be part of triple-combination. Low-dose spironolactone can be recommended in severe forms of hypertension. Pharmacological approach should involve also intervention of all other risk factors including BMI reduction in obese subjects. Some of new antidiabetic drugs may lead to significant BP decrease (gliflozines).

Key words:
diabetes mellitus – hypertension – treatment

Zdroje

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