Hypertension in diabetes mellitus type 2 - Evidence for the therapeutic approach

Abstract

Introduction: Hypertension (HT) is a very common health problem in patients with Diabetes Mellitus (DM), particularly in type 2 diabetes (T2DM), whose presence also implies a substantial increase in cardiovascular risk and may awaken or accelerate injuries micro and macrovascular complications of diabetes. Therefore, it becomes important to define the objectives and therapeutic management of hypertension in patients with T2DM based on current scientific evidence. Objective: To evaluate the "prior art" with respect to treatment of hypertension in patients with T2DM. Methodology: Review of the medical literature for specific therapeutic approaches to hypertension in T2DM, including the recommendations of scientific societies, clinical guidelines already approved and randomized trials for the treatment of hypertension that include diabetic patients and report results taking into account the global cardiovascular complications and kidney. Results: The treatment of hypertension in diabetic patients results in benefits accented by a marked decrease of fatal cardiovascular events and nonfatal, in reducing microalbuminuria and progression to ESRD and death. Conclusions: In diabetic patients with hypertension, the target tension to achieve the best guarantee of achieving capacity binomial / optimization of cardiovascular benefits is a value less than 130 to 80 mm Hg. To do this, beyond any possible intervention on adherence to healthy lifestyle habits, any drug therapy produces significant results and should be individualized to the specific characteristics of the overall risk of each patient. However, evidence seems to appear that using converting enzyme inhibitors and angiotensin receptor antagonists isolates, combined with diuretics or with each other can improve the quality of life for diabetic hypertensive patient, especially if there is already renal injury.