a practical approach to hypertension management in diabetes

a practical approach to hypertension management in diabetes

What is the approach of treatment for hypertension?

Lifestyle changes should be the initial approach to hypertension management and include dietary interventions (reducing salt, increasing potassium, alcohol avoidance, and multifactorial diet control), weight reduction, tobacco cessation, physical exercise, and stress management.

What are the two treatment approaches in the management of hypertension?

The two main interventional approaches, transcatheter renal denervation and baroreflex activation therapy, are used in clinical practice for severe treatment resistant hypertension in some countries.

Which ACE inhibitor is best for diabetics?

Captopril is the only FDA-approved ACE inhibitor for diabetic nephropathy although other ACE inhibitors may be as effective. Several studies demonstrated that lisinopril is effective in the reducing urinary albumin excretion in diabetes[2].

Which antihypertensive is safe in diabetes?

In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them.

What is the first-line treatment for hypertension?

Initial first-line therapy for stage 1 hypertension includes thiazide diuretics, CCBs, and ACE inhibitors or ARBs. Two first-line drugs of different classes are recommended with stage 2 hypertension and average BP of 20/10 mm Hg above the BP target.

What is the first step in the treatment of hypertension?

Diuretics are the first step in the treatment of most patients with hypertension and the new clinical trials should focus on drugs to be added to them as the second step in the management of hypertension.

What are compelling indications for hypertension?

Compelling indications may include high-risk conditions that can be direct sequelae of hypertension (heart failure, ischemic heart disease, chronic kidney disease, recurrent stroke) or that are commonly associated with hypertension (diabetes, high coronary disease risk), as well as drug intolerability or …

Why is lisinopril given to diabetics?

In people with diabetes, lisinopril helps prevent kidney disease from progressing and reduces the amount of protein that goes unfiltered by the kidneys and ends up in urine (a.k.a. proteinuria).

Why do diabetics need ACE inhibitors?

By reducing blood pressure and fluid retention, ACE inhibitors help to prevent heart failure. ACE inhibitors may also prevent and control diabetic nephropathy (kidney disease) and help control diabetic retinopathy (eye problems). ACE inhibitors do not slow the heart or directly lower blood sugar.

When Should ACE inhibitors be used in diabetes?

8 The National Kidney Foundation recommends an ACE inhibitor or ARB in normotensive patients with diabetes and an albumin level greater than 30 mg per g who are at high risk of CKD or progression.

What is diabetic hypertensive?

Hypertension, or high blood pressure, often occurs alongside diabetes mellitus, including type 1, type 2, and gestational diabetes, and studies show there may be links between them. Hypertension and type 2 diabetes are both aspects of metabolic syndrome, a condition that includes obesity and cardiovascular disease.

Is Hydrochlorothiazide good for diabetics?

While thiazide diuretics are still a recommended medication of hypertension therapy for type 2 diabetes, treatment with low-dose HCTZ should be attempted to evaluate the effectiveness and adverse metabolic effects.

Which diuretic is good for diabetics?

We conclude that Indapamide is safe and effective in lowering blood pressure and contributes to better control of blood glucose and lipid levels in diabetic and dyslipidemic patients, compared to standard diuretics.

When should you start treating hypertension?

If you’re 60 or older, the American College of Physicians and the American Academy of Family Physicians recommend you start treatment if your top blood pressure number is 130 or higher.

What is the management of hypotension?

Drink more water. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension. Wear compression stockings. The elastic stockings commonly used to relieve the pain and swelling of varicose veins can help reduce the pooling of blood in your legs.

What are compelling indications?

Compelling Indications. Compelling indications for specific therapy include high-risk conditions that can be direct sequelae of hypertension (heart failure, coronary heart disease, chronic kidney disease, recurrent stroke) or commonly associated with hypertension (diabetes, high coronary heart disease risk).

Why is monotherapy in the management of hypertension is not effective?

Furthermore, no matter which drug or drug dose is used, monotherapy cannot control BP in many hypertensive patients, its BP-lowering ability being particularly limited in important clinical subgroups, such as in patients with isolated systolic hypertension, advanced organ damage, or diabetes mellitus.

Which are the drugs for 3rd line treatment of hypertension?

Diuretics were the most frequently prescribed third-line antihypertensive in patients receiving an ARB in combination with a CCB. In addition, we found that the decision to add other antihypertensive drugs was made within the first 1 or 2 years of initiation of ARB therapy.

Should all diabetics be on lisinopril?

Ideally, therefore, all diabetic patients with renal or cardiovascular disease should be treated with ACE inhibitors or ARBs.

What is metoprolol succinate used for?

Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to prevent angina (chest pain) and to improve survival after a heart attack. Metoprolol also is used in combination with other medications to treat heart failure.