Managing hypertension in type 2 diabetes mellitus

Best Pract Res Clin Endocrinol Metab. 2016 Jun;30(3):445-54. doi: 10.1016/j.beem.2016.06.001. Epub 2016 Jun 11.

Abstract

Hypertension is a common problem in the diabetic population with estimates suggesting a prevalence exceeding 60%. Comorbid hypertension and diabetes mellitus are associated with high rates of macrovascular and microvascular complications. These two pathologies share overlapping risk factors, importantly central obesity. Treatment of hypertension is unequivocally beneficial and improves all-cause mortality, cardiovascular mortality, major cardiovascular events, and microvascular outcomes including nephropathy and retinopathy. Although controversial, current guidelines recommend a target blood pressure in the diabetic population of <140/90 mmHg, which is a similar target to that proposed for individuals without diabetes. Management of blood pressure in patients with diabetes includes both lifestyle modifications and pharmacological therapies. This article reviews the evidence for management of hypertension in patients with type 2 diabetes mellitus, and provides a recommended treatment strategy based on the available data.

Keywords: diabetes mellitus; hypertension; pharmacology.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use*
  • Diabetes Mellitus, Type 2 / complications*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / etiology

Substances

  • Antihypertensive Agents