Treatment of hypertension in diabetes: what is the best therapeutic option?

Abstract

Patients with diabetes mellitus have a high risk of cardiovascular disease, and the latter is the leading cause of premature mortality in diabetic patients. Treatment of risk factors and comorbidities, such as hypertension, is very important and may effectively prevent cardiovascular events. The blood pressure goal in diabetic patients should be below 140/90 mmHg, probably down to 130–135/85 mmHg, although the evidence for this is scarce. To reach this blood pressure goal, intensive lifestyle intervention and often combinations of different antihypertensive drugs must be initiated. In combination treatment, a blocker of the renin–angiotensin system should be included, and according to the results of the ACCOMPLISH trial, a combination of a renin–angiotensin system blocker and a calcium channel blocker should probably be the first choice.

Keywords::

• β-blockers
• ACE inhibitors
• angiotensin II type 1 receptor blockers
• antihypertensive agents
• blood pressure
• calcium channel blockers
• diabetes mellitus
• diuretics
• hypertension

Financial & competing interests disclosure

TA Aksnes has received lecture fees from AstraZeneca, Novartis and MSD. SE Kjeldsen has received honoraria from AstraZeneca, Bayer, Boehringer-Ingelheim, Leo, Medtronic, Nycomed and Takeda, and also moderate research support from AstraZeneca and Pronova. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.