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Feature Article

Modern trends in managing hypertension in people with diabetes

Duygu Batu Demir, Mark E Cooper

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Abstract

The major cause of mortality in diabetes remains cardiovascular disease (CVD). Thus, any risk factors associated with CVD must be aggressively treated in patients with diabetes. Hypertension is one of these risk factors and should be appropriately managed in such individuals.

Key Points

  • The prevalence of hypertension in the population with diabetes is much higher than in the general population.
  • The significant benefits of lowering blood pressure (BP) in patients with diabetes have been confirmed in recent meta-analyses.
  • White coat hypertension and loss of diurnal variation are common in subjects with diabetes, so ambulatory BP monitoring is increasingly being used to measure and monitor BP in this population.
  • Management of hypertension in subjects with diabetes should be individualised, and the benefits and side effects of treatment considered when making decisions about target BP and choice of BP lowering medication.
  • Current guidelines have become less stringent in terms of initiation of BP lowering medications.
  • The advent of new glucose lowering drugs such as sodium-glucose cotransporter 2 inhibitors may provide clinicians with additional opportunity to reduce BP.

    Picture credit: © Bodell Communications, Inc/Phototake/Diomedia.com

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