Abstract
To characterize the association of diabetes and hypertension and to discuss management strategies. Published studies are summarized and various hypotheses are reviewed. Hypertension is a major determinant of the increased cardiovascular, peripheral vascular, and renal complications associated with diabetes. Recent evidence indicates that insulin resistance is one of the multiple key components of the pathophysiologic elements underlying the increased prevalence of hypertension associated with diabetes. In patients with diabetes, management of hypertension is frequently complicated by the coexistence of other macrovascular risk factors, including dyslipidemia, obesity, visceral adiposity, and poor glycemic control. The choice of antihypertensive agents in both type I and type II diabetes must be based on the selective metabolic, hormonal, and hemodynamic advantages and disadvantages of these agents in individual patients. Long-term trials are needed to determine the benefits, if any, of various angiotensin-converting enzyme inhibitors, calcium channel antagonists, and alpha1-adrenergic receptor antagonists in preventing the cardiovascular and the renal complications of diabetes.
References
Sep 1, 1992·Diabetes·W V MooreT B Wiegmann
Nov 1, 1991·Diabetes Care·C BerneH Lithell
Mar 1, 1990·The American Journal of Medicine·M TuckA Trujillo
Dec 1, 1988·Diabetes·G M Reaven
May 28, 1983·Lancet·H H ParvingP A Svendsen
Sep 1, 1994·Annals of Internal Medicine·J T InsuaT C Chalmers
Nov 1, 1994·Diabetes Care·L TarnowH H Parving
Aug 20, 1994·Lancet·B Williams
Oct 1, 1994·Diabetes·P L PoulsenC E Mogensen
Aug 1, 1994·Diabetes Care·R GilbertG Jerums
Dec 1, 1994·The Journal of Clinical Investigation·C L GabouryG H Williams
Jan 15, 1995·Annals of Internal Medicine·B L KasiskeT A Louis
Jun 30, 1994·The New England Journal of Medicine·D S SiscovickE H Wagner
Oct 1, 1993·Diabetes Care
Nov 11, 1993·The New England Journal of Medicine·E J LewisR D Rohde
Jan 15, 1993·Annals of Internal Medicine·B L KasiskeW F Keane
Feb 1, 1993·Hypertension·A D BaronD Hardin
Feb 1, 1993·Hypertension·E A Anderson, A L Mark
Feb 1, 1993·Diabetes Care·J StamlerD Wentworth
Mar 1, 1993·The Journal of Clinical Endocrinology and Metabolism·S M Haffner