PMID- 29704920
OWN - NLM
STAT- MEDLINE
DCOM- 20180831
LR  - 20181202
IS  - 1873-4111 (Electronic)
IS  - 0378-5122 (Linking)
VI  - 112
DP  - 2018 Jun
TI  - Hypertension in patients with type 2 diabetes mellitus: Targets and management.
PG  - 71-77
LID - S0378-5122(18)30141-5 [pii]
LID - 10.1016/j.maturitas.2018.03.013 [doi]
AB  - Two-thirds of patients with type 2 diabetes mellitus (T2DM) have arterial 
      hypertension. Hypertension increases the incidence of both micro- and 
      macrovascular complications in these patients, while the co-existence of these 
      two major risk factors leads to a four-fold increased risk for cardiovascular 
      disease (CVD) compared with normotensive non-diabetic controls. The aim of this 
      article is to comprehensively review the literature and present updated 
      information on targets for blood pressure (BP) and on the management of 
      hypertension in patients with T2DM. A BP target of <140/90 mmHg applies to most 
      patients, but individualization is always important. All classes of 
      antihypertensive drugs can be used in the management of hypertension in patients 
      with T2DM, as long as they are effective and safe and after taking co-morbidities 
      into account. Angiotensin-converting-enzyme (ACE) inhibitors or angiotensin 
      receptor blockers (ARBs) are the ideal choice for initial or early treatment of 
      hypertension in patients with T2DM and albuminuria. Combination of two or more 
      drugs seems to be inevitable as most of these patients demonstrate resistant 
      hypertension. The combination of ACE inhibitors with ARBs should be avoided. 
      Thiazide and thiazide-like diuretics might be beneficial, alone or in a 
      fixed-dose combination with ACE inhibitors or ARBs. Calcium channel blockers 
      (CCBs) constitute an ideal option as a second- or third-line agent. Beta-blockers 
      are not considered as first-line antihypertensive agents, except for those 
      patients with heart failure or previous myocardial infarction. The addition of 
      mineralocorticoid receptor antagonists to a triple-drug therapy seems the next 
      ideal step. Gender-specific characteristics regarding BP, T2DM and CVD should be 
      taken into consideration, even if different recommendations do not exist yet.
CI  - Copyright (c) 2018. Published by Elsevier B.V.
FAU - Pavlou, Dimitra I
AU  - Pavlou DI
AD  - Forth Department of Internal Medicine, Hippokration Hospital, Medical School, 
      Aristotle University of Thessaloniki, Thessaloniki, Greece.
FAU - Paschou, Stavroula A
AU  - Paschou SA
AD  - Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, 
      National and Kapodistrian University of Athens, Athens, Greece.
FAU - Anagnostis, Panagiotis
AU  - Anagnostis P
AD  - Unit of Reproductive Endocrinology, First Department of Obstetrics and 
      Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 
      Greece.
FAU - Spartalis, Michael
AU  - Spartalis M
AD  - Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
FAU - Spartalis, Eleftherios
AU  - Spartalis E
AD  - Laboratory of Experimental Surgery and Surgical Research, Medical School, 
      National and Kapodistrian University of Athens, Athens, Greece.
FAU - Vryonidou, Andromachi
AU  - Vryonidou A
AD  - Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, 
      Greece.
FAU - Tentolouris, Nicholas
AU  - Tentolouris N
AD  - Diabetes Center, First Department of Propaedeutic Internal Medicine, Laiko 
      General Hospital, Medical School, National and Kapodistrian University of Athens, 
      Greece.
FAU - Siasos, Gerasimos
AU  - Siasos G
AD  - First Department of Cardiology, Hippokration Hospital, Medical School, National 
      and Kapodistrian University of Athens, Athens, Greece. Electronic address: 
      gsiasos@med.uoa.gr.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180330
PL  - Ireland
TA  - Maturitas
JT  - Maturitas
JID - 7807333
RN  - 0 (Antihypertensive Agents)
SB  - IM
MH  - Albuminuria/complications
MH  - Antihypertensive Agents/*therapeutic use
MH  - Cardiovascular Diseases/etiology
MH  - Diabetes Mellitus, Type 2/*complications/*drug therapy
MH  - Diabetic Angiopathies/*drug therapy
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Hypertension/*complications/*drug therapy
MH  - Risk Factors
MH  - Sex Factors
OTO - NOTNLM
OT  - Hypertension
OT  - Management
OT  - Targets
OT  - Type 2 diabetes
EDAT- 2018/05/01 06:00
MHDA- 2018/09/01 06:00
CRDT- 2018/04/30 06:00
PHST- 2018/02/26 00:00 [received]
PHST- 2018/03/24 00:00 [revised]
PHST- 2018/03/29 00:00 [accepted]
PHST- 2018/04/30 06:00 [entrez]
PHST- 2018/05/01 06:00 [pubmed]
PHST- 2018/09/01 06:00 [medline]
AID - S0378-5122(18)30141-5 [pii]
AID - 10.1016/j.maturitas.2018.03.013 [doi]
PST - ppublish
SO  - Maturitas. 2018 Jun;112:71-77. doi: 10.1016/j.maturitas.2018.03.013. Epub 2018 
      Mar 30.