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The Treatment of Hypertension in Adult Patients With Diabetes
Open accessAbstract
Hypertension is an extremely common comorbidity of diabetes, affecting 20–60% of people with diabetes. Hypertension is also a major risk factor for cardiovascular events, such as myocardial infarction and stroke, as well as for microvascular complications, such as retinopathy and nephropathy. Cardiovascular disease is the most costly complication of diabetes and is the cause of 86% of deaths in persons with diabetes (1). However, until recently, little research had been done specifically in patients with diabetes and hypertension. In reviewing the literature on diabetes and hypertension, the authors searched MEDLINE for English language articles using keywords “hypertension,” “diabetes mellitus,” “diabetic nephropathy,” and “coronary artery disease/prevention” starting from 1966. Before 1996, most available data come from secondary analysis from studies done in the general population of people with hypertension, observing a subset with diabetes. Recent studies have demonstrated the effectiveness of blood pressure treatment versus placebo in reducing complications of diabetes (2,3), helped to define the optimal level of blood pressure control (4,5,6), and compared treatment strategies based on different drug classes (7,8,9,10,11,12,13). The results of these studies support an aggressive approach to the diagnosis and treatment of hypertension in patients with diabetes in order to substantially reduce the incidence of both macrovascular and microvascular complications. ### Definition of hypertension in diabetic populations Epidemiological studies and therapeutic trials have often used different criteria to define hypertension in diabetic patients. Studies in the general population indicate an increased risk of cardiovascular disease with an increase in the level of blood pressure. Thus, an increase in diastolic or systolic blood pressure of 5 mmHg is associated with a concomitant increase in cardiovascular disease of 20–30% (14). Studies in diabetic populations have shown a markedly higher frequency of the progression of diabetic retinopathy …
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“weight loss of 1 kilogram has been reported to decrease mean arterial blood pressure by approximately 1 mm Hg.”
From The case for low carbohydrate diets in diabetes management (2005) · cites this paper as [74]
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Nowy rok, stare problemy, ale i nowe możliwości
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BackgroundInfluentialHypertension Management in Adults With Diabetes
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ResultThe Asheville Project: Short-Term Outcomes of a Community Pharmacy Diabetes Care Program
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“and women, by ethnicity (African-American, Hispanic, or Caucasian), in comparison to those without diabetes, and by treatment status [28,29].”
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“…if attention is focused on more rigorous control of blood pressure with a goal of <130/80 mm Hg and lipids, with an LDL goal of <100 mg/dl, and treatment with anti-platelet agents, the macrovascular complications of diabetes can be reduced [Arauz-Pacheco et al. 2002; Haffner, 1998; Colwell, 1997].”
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“Moreover, patients with diabetes and hypertension have about twice the risk of cardiovascular events as nondiabetic patients with hypertension (83).”
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Diabetes and Hypertension: Pathogenesis, Prevention and Treatment
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“The relationship between hypertension and weight loss is well documented [13,74] and weight loss of 1 kilogram has been reported to decrease mean arterial blood pressure by approximately 1 mm Hg.”
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Antihypertensive Agents for Primary Prevention of Diabetic Nephropathy
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Effect of Losartan on Microalbuminuria in Normotensive Patients with Type 2 Diabetes Mellitus
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“The current definition of normotension is a blood pressure less than 140/90 mm Hg, with a blood pressure– lowering target of less than 130/80 mm Hg in hypertensive adults with diabetes mellitus (25, 26); however, we developed the protocol for this study in 1998, when normotension was defined as a sitting blood pressur…”
Diabetes and cardiovascular disease: inter-relation of risk factors and treatment
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“in a clinical trial, the sodium intake was reduced from 4600mg to 2300mg [175] -Reduced pressure of blood (systolic approx.”
BackgroundDiabetes knowledge and glycemic control among Chinese people with type 2 diabetes
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“Furthermore, it has been clearly shown that hypertension in diabetic patients is associated with accelerated progression of both microvascular (retinopathy and nephropathy) and macrovascular (atherosclerotic) complications [5].”
BackgroundAntihypertensive agents for preventing diabetic kidney disease
Strippoli, G. F., Craig, M. E., Craig, J. C., Lv, J., & Perkovic, V. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004136.pub2 · Cited by 59
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“About one third of type 1 diabetic adults may develop hypertension with advancing duration of diabetes [2].”
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“Because hypertension is a precursor to multiple disease conditions, maintaining blood pressure (BP) control and adherence to goals are imperative to reducing morbidity and mortality, especially in patients with high risk.(2,3) Since its first report in 1977, the Joint National Committee on the Prevention, Detection, E…”
BackgroundMacrovascular angiopathy in children and adolescents with type 1 diabetes
Giannini, C., Mohn, A., Chiarelli, F., & Kelnar, C. J. H. (2011) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.1195 · Cited by 55
Treatment of Hypertension in Adults With Diabetes
American Diabetes Association (2002) · Diabetes Care · doi:10.2337/diacare.25.2007.s71 · Cited by 50
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Lifestyle Modification to Improve Blood Pressure Control in Individuals With Diabetes
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“Nearly 60% of adults with diabetes have comorbid hypertension (4,5), and data suggest that when diabetes and hypertension coexist, the risk for cardiovascular events doubles (6).”
BackgroundEffect of telmisartan on cardiovascular complications associated with streptozotocin diabetic rats
Goyal, B. R., Mesariya, P., Goyal, R. K., & Mehta, A. A. (2008) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-008-9772-y · Cited by 48
“Hypertension is an extremely common comorbid condition affecting approximately 20–60% of patients with diabetes, depending on obesity, ethnicity, and age [3].”
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Insulin resistance and hypertension in patients with type 1 diabetes
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“Diabetes and HT coexist in approximately 40%–60% of patients with type 2 diabetes.[17,18] Sixty‐five percent patients had a relative or sibling who also suffered from DM.”
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“Adequate treatment of hypertension has acquired a major importance in the overall management of individuals with type 2 diabetes (24).”
BackgroundEndothelial dysfunction and hypertension in diabetes mellitus
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“The ADA, the National Kidney Foundation, and JNC VII advocate lowering blood pressure to less than 130/80 mm Hg in patients who have diabetes mellitus [116–118].”
BackgroundPharmacologic management of hypertension in patients with diabetes.
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Management of Blood Pressure in Patients With Diabetes
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Heart Failure in Diabetes and Related Conditions
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Stroke prevention in diabetes and obesity
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Metadata
- Authors
- Arauz-Pacheco, C., Parrott, M. A., & Raskin, P.
- Affiliations
- George Washington University (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2002-01-01
- Volume
- 25
- Issue
- 1
- Pages
- 134-147
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2138299277
- Cited by
- 326
- References
- 129
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 7 · 2020: 11 · 2019: 8 · 2018: 4 · 2017: 14 · 2016: 14 · 2015: 15 · 2014: 16 · 2013: 12 · 2012: 19
- FWCI
- 4.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- hypertension, diabetes mellitus, antihypertensive therapy, blood pressure control, diabetic nephropathy, diabetic retinopathy, cardiovascular complications, microvascular complications, antihypertensive drug classes
- MeSH terms
- Adult, Diabetic Angiopathies, Female, Humans, Hypertension, Lactation, Pregnancy, Pregnancy in Diabetics, Prevalence
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