Optimizing antihypertensive therapy in patients with diabetes mellitus
Optimizing antihypertensive therapy in patients with diabetes mellitus
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DOI：
10.1038/s41440-022-01150-5
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发表时间：
2022-12
影响因子：
5.4
通讯作者：
Wenhao Liu;Y. Higashikuni;M. Sata
中科院分区：
文献类型：
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作者：
Wenhao Liu;Y. Higashikuni;M. Sata
高血压是糖尿病（DM）患者的常见疾病[1]。与单独的DM或高血压相比，DM和高血压的共存协同增加了大血管和微血管并发症的风险，包括冠心病、外周动脉疾病、卒中、视网膜病和肾病，以及左心室肥大和充血性心力衰竭[2]。临床试验表明，充分控制血压（BP）可显著降低糖尿病患者发生这些并发症的风险[2]。另一方面，据报道，许多高血压DM患者无法达到最佳BP目标，这可能归因于DM的病理生理学、治疗惰性或患者相关因素，包括药物依从性差和难以获得专科护理[2]。由于高血压和糖尿病的患病率在全球范围内不断增加[1]，特别是在老年人群中，糖尿病患者的高血压管理是公共卫生和临床实践中的一个重要课题，在本期《高血压研究》中，Gnanenthiran等人提供了关于降压治疗对高血压合并糖尿病患者的疗效的重要信息[3]。作者分析了轻中度高血压患者三联药丸与药物治疗管理（TRIUMPH）研究的数据，这是一项随机、对照、开放标签试验，纳入了700例轻度或中度高血压患者，这些患者需要开始或增加
Hypertension is a common morbidity in patients with diabetes mellitus (DM)[1]. The coexistence of DM and hypertension synergistically increases the risk for macrovascular and microvascular complications, including coronary heart disease, peripheral artery disease, stroke, retinopathy, and nephropathy, as well as left ventricular hypertrophy and congestive heart failure, compared with DM or hypertension alone [2]. Clinical trials have demonstrated that adequate control of blood pressure (BP) significantly reduces the risk of these complications in diabetic patients [2]. On the other hand, it has been reported that many hypertensive patients with DM do not achieve optimal BP targets, which might be attributable to the pathophysiology of DM, therapeutic inertia, or patient-related factors, including poor medication adherence and difficulties in accessing specialist care [2]. Since the prevalence of hypertension and DM has been increasing worldwide [1], especially in the aged population, the management of hypertension in diabetic patients is an important topic in public health and clinical practice.In this issue of Hypertension Research, Gnanenthiran et al. provided important information on the efficacy of BP-lowering therapies in hypertensive patients with DM [3]. The authors analyzed the data from the Triple Pill vs. Usual Care Management for Patients with Mild-to-Moderate Hypertension (TRIUMPH) study, a randomized, controlled, open-label trial of 700 patients with mild or moderate hypertension who required an initiation or escalation of