Abstract

MANAGEMENT OF BLOOD PRESSURE IN PATIENTS WITH CONCURRENT HYPERTENSION AND DIABETES: A REVIEW

A. R. Shabaraya and Sabtha Hakmal*

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Abstract

The co-existence of hypertension and diabetes, both being major risk factors for cardiovascular events, increase the occurrence of possible microvascular and macro-vascular complications. Treatment of hypertension in patients with diabetes is challenging due to their higher risk of developing resistant hypertension and their lower tolerance to aggressive antihypertensive treatment. The optimal blood pressure range for hypertensive diabetic patients is slightly different in different standard guidelines, which over years of research produced a range that may result in the best possible health outcome, yet the recent studies have different suggestions on debate. The management of hypertension in diabetes requires a strategic approach in accordance with the standard guidelines, and on the basis of cardiovascular status and complex metabolic derangements seen in the population subgroup. Although the aggressive management of blood pressure remains to be the initial approach in all patients with hypertension regardless of the comorbid conditions, there are certain clinical trials that prove in contrast with the recommended strategies. All the major antihypertensive classes of drugs are used in patients with diabetes, but certain classes of drugs such as beta-blockers have been reported to have a negative impact on diabetes, which must be reconsidered for their risks over benefits before administration. The objective of this review is to discuss target blood pressure goals, strategic approach and choice of agents for the treatment of hypertension in patients with concurrent diabetes. In this study, we also assess the impact of hypertension therapy on diabetes and their associated complications.

Keywords: Antihypertensive treatment, concurrent diabetes, blood pressure management, aggressive BP control, cardiovascular risks.