Blood Pressure Control in Type 2 Diabetic Patients

Overview

Journal Cardiovasc Diabetol

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
Endocrinology

Date 2017 Jan 7

PMID 28056987

Citations 46

Authors

Alon Grossman

Ehud Grossman

Affiliations

Soon will be listed here.

Abstract

Diabetes mellitus (DM) and essential hypertension are common conditions that are frequently present together. Both are considered risk factors for cardiovascular disease and microvascular complications and therefore treatment of both conditions is essential. Many papers were published on blood pressure (BP) targets in diabetic patients, including several works published in the last 2 years. As a result, guidelines differ in their recommendations on BP targets in diabetic patients. The method by which to control hypertension, whether pharmacological or non-pharmacological, is also a matter of debate and has been extensively studied in the literature. In recent years, new medications were introduced for the treatment of DM, some of which also affect BP and the clinician treating hypertensive and diabetic patients should be familiar with these medications and their effect on BP. In this manuscript, we discuss the evidence supporting different BP targets in diabetics and review the various guidelines on this topic. In addition, we discuss the various options available for the treatment of hypertension in diabetics and the recommendations for a specific treatment over the other. Finally we briefly discuss the new diabetic drug classes and their influence on BP.

Citing Articles

Pilot-Scale Production of Sericin-Derived Oligopeptides (SDOs) from Yellow Silk Cocoons: Peptide Characterization and Specifications.

Sangsawad P, Chumee S, Laosam P, Roytrakul S, Katemala S, Sutheerawattananonda M Foods. 2025; 14(3).

PMID: 39942094 PMC: 11818041. DOI: 10.3390/foods14030500.

Hypertension in Adults With Diabetes in Southeast Asia: A Systematic Review.

Wong W, Van Nguyen T, Ahmad F, Vu H, Koh A, Tan K J Clin Hypertens (Greenwich). 2024; 27(1):e14936.

PMID: 39545715 PMC: 11771803. DOI: 10.1111/jch.14936.

Association of hypertension defined by the 2017 ACC/AHA guideline and choroidal thickness changes in type 2 diabetes: a 2-year longitudinal study.

Liu K, Fu Y, Ye M, Liu R, Li T, Mao Y Eye (Lond). 2024; 39(1):162-169.

PMID: 39533035 PMC: 11733246. DOI: 10.1038/s41433-024-03401-w.

Effect of dipeptidyl peptidase-4 inhibitors on tumor necrosis factor alpha levels in patients with type 2 diabetes mellitus.

Zhao L, Meng J, Bai X, Zhang D, Yang X, Yang Y Eur J Med Res. 2024; 29(1):363.

PMID: 38997754 PMC: 11241791. DOI: 10.1186/s40001-024-01955-9.

Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines.

Bhalla H, Huang G, Seaman K, Silva S, Wu B, Wabe N Australas J Ageing. 2024; 43(4):792-801.

PMID: 38961713 PMC: 11671704. DOI: 10.1111/ajag.13351.

References

Bakris G, Agarwal R, Chan J, Cooper M, Gansevoort R, Haller H . Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy: A Randomized Clinical Trial. JAMA. 2015; 314(9):884-94. DOI: 10.1001/jama.2015.10081. View

Sowers J . Recommendations for special populations: diabetes mellitus and the metabolic syndrome. Am J Hypertens. 2003; 16(11 Pt 2):41S-45S. DOI: 10.1016/j.amjhyper.2003.07.009. View

Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo Jr J . The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003; 289(19):2560-72. DOI: 10.1001/jama.289.19.2560. View

Weber M, Mansfield T, Alessi F, Iqbal N, Parikh S, Ptaszynska A . Effects of dapagliflozin on blood pressure in hypertensive diabetic patients on renin-angiotensin system blockade. Blood Press. 2015; 25(2):93-103. DOI: 10.3109/08037051.2015.1116258. View

Grossman E, Messerli F . Management of blood pressure in patients with diabetes. Am J Hypertens. 2011; 24(8):863-75. DOI: 10.1038/ajh.2011.77. View

Ettehad D, Emdin C, Kiran A, Anderson S, Callender T, Emberson J . Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016; 387(10022):957-967. DOI: 10.1016/S0140-6736(15)01225-8. View

Weitzman D, Chodick G, Shalev V, Grossman C, Grossman E . Prevalence and factors associated with resistant hypertension in a large health maintenance organization in Israel. Hypertension. 2014; 64(3):501-7. DOI: 10.1161/HYPERTENSIONAHA.114.03718. View

Kato S, Maruyama S, Makino H, Wada J, Ogawa D, Uzu T . Anti-albuminuric effects of spironolactone in patients with type 2 diabetic nephropathy: a multicenter, randomized clinical trial. Clin Exp Nephrol. 2015; 19(6):1098-106. PMC: 4577308. DOI: 10.1007/s10157-015-1106-2. View

Pop-Busui R . Cardiac autonomic neuropathy in diabetes: a clinical perspective. Diabetes Care. 2010; 33(2):434-41. PMC: 2809298. DOI: 10.2337/dc09-1294. View

10.

Krause T, Lovibond K, Caulfield M, McCormack T, Williams B . Management of hypertension: summary of NICE guidance. BMJ. 2011; 343:d4891. DOI: 10.1136/bmj.d4891. View

11.

Brown M, CASTAIGNE A, de Leeuw P, Mancia G, Palmer C, Rosenthal T . Influence of diabetes and type of hypertension on response to antihypertensive treatment. Hypertension. 2000; 35(5):1038-42. DOI: 10.1161/01.hyp.35.5.1038. View

12.

Cushman W, Evans G, Byington R, Goff Jr D, Grimm Jr R, Cutler J . Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010; 362(17):1575-85. PMC: 4123215. DOI: 10.1056/NEJMoa1001286. View

13.

Shlomai G, Kopel E, Goldenberg I, Grossman E . Temporal trends in management of hypertension among Israeli adults, 2002-2010: lesson from the Acute Coronary Syndromes Israeli Survey (ACSIS). J Am Soc Hypertens. 2013; 8(2):94-102. DOI: 10.1016/j.jash.2013.08.004. View

14.

Cooper-DeHoff R, Gong Y, Handberg E, Bavry A, Denardo S, Bakris G . Tight blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary artery disease. JAMA. 2010; 304(1):61-8. PMC: 3008411. DOI: 10.1001/jama.2010.884. View

15.

Demarie B, Bakris G . Effects of different calcium antagonists on proteinuria associated with diabetes mellitus. Ann Intern Med. 1990; 113(12):987-8. DOI: 10.7326/0003-4819-113-12-987. View

16.

Tikkanen I, Narko K, Zeller C, Green A, Salsali A, Broedl U . Empagliflozin reduces blood pressure in patients with type 2 diabetes and hypertension. Diabetes Care. 2014; 38(3):420-8. DOI: 10.2337/dc14-1096. View

17.

Yusuf S, Diener H, Sacco R, Cotton D, Ounpuu S, Lawton W . Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med. 2008; 359(12):1225-37. PMC: 2714258. DOI: 10.1056/NEJMoa0804593. View

18.

James P, Oparil S, Carter B, Cushman W, Dennison-Himmelfarb C, Handler J . 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2013; 311(5):507-20. DOI: 10.1001/jama.2013.284427. View

19.

Derosa G, Querci F, Franzetti I, Dario Ragonesi P, DAngelo A, Maffioli P . Comparison of the effects of barnidipine+losartan compared with telmisartan+hydrochlorothiazide on several parameters of insulin sensitivity in patients with hypertension and type 2 diabetes mellitus. Hypertens Res. 2015; 38(10):690-4. DOI: 10.1038/hr.2015.57. View

20.

Hansson L, Zanchetti A, Carruthers S, Dahlof B, Elmfeldt D, Julius S . Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998; 351(9118):1755-62. DOI: 10.1016/s0140-6736(98)04311-6. View