Patient Management of Hypertensive Subjects without and with Diabetes Mellitus Type II

Med Clin North Am. 2017 Jan;101(1):159-167. doi: 10.1016/j.mcna.2016.08.014.

Abstract

The description of blood pressure (BP) curve has evolved to include several noninvasively determined parameters, such as aortic stiffness, BP variability, wave reflections, and pulse pressure amplification. These techniques are likely to improve the efficacy of assessing pulsatile arterial hemodynamics and changes in arterial stiffness. The goal for future antihypertensive treatments should not only reduce steady BP, but also control pulsatile pressure and modify the stiffness gradient between central and peripheral arteries, which is frequently elevated. These changes have the potential to reduce residual cardiovascular risk but also to define drug strategies adapted to the needs of individual hypertensive subjects.

Keywords: Arterial stiffness; Blood pressure; Hypertension management; Wave reflection.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Calcium Channel Blockers / therapeutic use
  • Diabetes Mellitus, Type 2 / complications*
  • Diuretics / therapeutic use
  • Drug Therapy, Combination
  • Humans
  • Hypertension / complications*
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Vascular Stiffness / drug effects

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Diuretics