Diabetes and hypertension, the deadly duet: Importance, therapeutic strategy, and selection of drug therapy
Diabetes and hypertension, the deadly duet: Importance, therapeutic strategy, and selection of drug therapy
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DOI：
10.1016/j.ccl.2004.06.006
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发表时间：
2005-05-01
影响因子：
2.4
通讯作者：
Deedwania, PC
中科院分区：
文献类型：
--
作者：
Deedwania, PC
高血压和糖尿病的共存显著且协同地增加了微血管和大血管并发症的风险。压倒性的证据支持积极治疗糖尿病患者的高血压。严格的血压控制是成本效益，比血糖控制更有益。糖尿病患者血压控制的最佳目标应为130/80 mm Hg。在患有糖尿病和肾功能不全的受试者中，血压应降至125/75 mm Hg，以延缓肾衰竭的进展。抗高血压药物的选择应基于已证实的对发病率和死亡率的影响，而不是替代参数，例如hpid或葡萄糖。有限的数据表明，血管紧张素转换酶（ACE）抑制剂是首选药物，特别是在那些有蛋白尿或肾功能不全。β-受体阻滞剂可作为治疗糖尿病合并冠心病的一线药物。
The coexistence of hypertension and diabetes dramatically and synergistically increases the risk of microvascular and macrovascular complications. Overwhelming evidence supports aggressive treatment of hypertension in diabetic patients. Tight blood pressure control is cost-effective and is more rewarding than glycemic control. The optimal goal of blood pressure control in diabetics should be 130/80 mm Hg. In subjects who have diabetes and renal insufficiency, the blood pressure should be lowered to 125/75 mm Hg to delay the progression of renal failure. The choice of an antibypertensive agent should be based on proven effects on morbidity and mortality rather than on surrogate parameters, such as hpid or glucose. Limited data suggest that an angiotensin-converting enzyme (ACE) inhibitor is the agent of choice, especially in those who have proteinuria or renal insufficiency. beta-Blockers can be the first-line agent in diabetics who have coronary heart.