ABSTRACT
Increases in blood pressure, even at modest levels, are associated with an increased
risk of complications in diabetes. Trials have shown that treatment with blood pressure-lowering
agents in type 2 diabetes lowers the risk of complications of cardiovascular and microvascular
complications. ACE inhibitors appear superior in patients with microalbuminuria, although
the choice of other agents is less clear, making blood pressure control itself more
important than the particular agent used. The probability that a patient will require
multiple therapies is increased in patients with diabetes, in part because of the
increased likelihood of concurrent cardiovascular illness for which antihypertensives
may have benefit. Finally, some drugs used to lower blood pressure have a benefit
in individuals not considered hypertensive and appear to have a mechanism of action
independent of blood pressure lowering.
KEYWORDS
Diabetes - ACE inhibitors - calcium channel blockers - diuretics - blood-pressure
lowering
