Diabetes mellitus a hypertenze

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Title in English Diabetes mellitus and hypertension
Authors

ŠPÁC Jiří KIANIČKA Bohuslav

Year of publication 2010
Type Article in Periodical
Magazine / Source Postgraduální medicina
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords treatment of hypertension diabetes nellitus
Description Antihypertensive therapy has cardioprotective and nephroprotective effects in patients with type 2 diabetes mellitus. ACE inhibitors, AT1-blockers, which improve insulin sensitivity, are the basis for treatment of hypertensive patients with diabetes. Renin inhibitors are a new drug class. In second line we use calcium channel blockers, particularly of dihydropyridine type, which are metabolically neutral. On the other side beta-blockers and diuretics, particularly thiazide, have metabolically unfavorable effects. It is suitable to choose cardioselective beta-blockers or beta-blockers from the class with associated vasodilatory capacity. Diuretics should be chosen maximally in combination and in small doses, especially potassium-sparing agents or diuretics of the apparently metabolically neutral indapamide type. Given the difficulty of achieving the target BP between 130-139/80-85 mmHg, it is necessary to maximize the use of combination therapy, in which the basis should be AT1-blockers or ACE inhibitors in combination with calcium channel blockers or diuretics. Blood pressure reduction is more important than the choice of antihypertensive drugs itself.
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