J Korean Diabetes.  2016 Jun;17(2):88-95. 10.4093/jkd.2016.17.2.88.

Management of Hypertension in Diabetic Patients

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Korea. diabetes@chosun.ac.kr

Abstract

Diabetes mellitus is a major chronic disease worldwide, and its prevalence is expected to increase in the near future. Because cardiovascular disease continues to be the leading cause of morbidity and mortality in diabetic patients, it is important to detect and address other risk factors of cardiovascular disease such as hypertension and dyslipidemia. Moreover, presence of diabetes increases the risk of developing hypertension. Despite significant advances in the understanding of the pathophysiology and treatment of hypertension, there are still many debates regarding the management of hypertension, especially in patients with diabetes. The most important unresolved questions are at what blood pressure to initiate drug therapy and the target blood pressure. Recently, the Korean Diabetes Association published "Treatment Guideline for Diabetes 2015." This review will compare major guidelines from other countries and discuss how to determine the target goal for blood pressure control in Korean diabetic patients.

Keyword

Diabetes mellitus; Hypertension; Treatment guideline

MeSH Terms

Blood Pressure
Cardiovascular Diseases
Chronic Disease
Diabetes Mellitus
Drug Therapy
Dyslipidemias
Humans
Hypertension*
Mortality
Prevalence
Risk Factors

Reference

References

1. Korean Diabetes Association. Treatment guideline for diabetes. 5th ed.Seoul: Gold' Planning and Development;2015.
2. Volpe M, Battistoni A, Savoia C, Tocci G. Understanding and treating hypertension in diabetic populations. Cardiovasc Diagn Ther. 2015; 5:353–63.
3. Kotchen TA. Developing hypertension guidelines: an evolving process. Am J Hypertens. 2014; 27:765–72.
Article
4. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F. Task Force Members. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281–357.
5. Go AS, Bauman MA, Coleman King SM, Fonarow GC, Lawrence W, Williams KA, Sanchez E. American Heart Association; American College of Cardiology; Centers for Disease Control and Prevention. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878–85.
6. Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, Flack JM, Carter BL, Materson BJ, Ram CV, Cohen DL, Cadet JC, Jean-Charles RR, Taler S, Kountz D, Townsend R, Chalmers J, Ramirez AJ, Bakris GL, Wang J, Schutte AE, Bisognano JD, Touyz RM, Sica D, Harrap SB. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens. 2014; 32:3–15.
7. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507–20.
8. NICE. Type 2 diabetes: guideline consultation. Available from:. https://www.nice.org.uk/guidance/indevelopment/gid-cgwave0612. (updated 2015 Dec 2).
9. Weber MA. Recently published hypertension guidelines of the JNC 8 panelists, the American Society of Hypertension/International Society of Hypertension and other major organizations: introduction to a focus issue of the Journal of Clinical Hypertension. J Clin Hypertens (Greenwich). 2014; 16:241–5.
10. Thomas G, Shishehbor M, Brill D, Nally JV Jr. New hypertension guidelines: one size fits most? Cleve Clin J Med. 2014; 81:178–88.
Article
11. Navar-Boggan AM, Pencina MJ, Williams K, Sniderman AD, Peterson ED. Proportion of US adults potentially affected by the 2014 hypertension guideline. JAMA. 2014; 311:1424–9.
Article
12. ACCORD Study Group. Cushman WC, Evans GW, Byington RP, Goff DC Jr, Grimm RH Jr, Cutler JA, Simons-Morton DG, Basile JN, Corson MA, Probstfield JL, Katz L, Peterson KA, Friedewald WT, Buse JB, Bigger JT, Gerstein HC, IsmailBeigi F. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010; 362:1575–85.
Article
13. Bangalore S, Kumar S, Lobach I, Messerli FH. Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta-analyses of randomized trials. Circulation. 2011; 123:2799–810.
14. ADA. Standards of medical care in diabetes-2013. Diabetes Care. 2013; 36:S11–66.
15. Hansson L, Zanchetti A, Carruthers SG, Dahlöf B, Elmfeldt D, Julius S, Ménard J, Rahn KH, Wedel H, Westerling S. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet. 1998; 351:1755–62.
16. McBrien K, Rabi DM, Campbell N, Barnieh L, Clement F, Hemmelgarn BR, Tonelli M, Leiter LA, Klarenbach SW, Manns BJ. Intensive and standard blood pressure targets in patients with type 2 diabetes mellitus: systematic review and metaanalysis. Arch Intern Med. 2012; 172:1296–303.
17. ADA. Standards of medical care in diabetes-2015. Cardiovascular disease and risk management. Diabetes Care. 2015; 38:S49–57.
18. Shimamoto K, Ando K, Fujita T, Hasebe N, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ishimitsu T, Ito M, Ito S, Itoh H, Iwao H, Kai H, Kario K, Kashihara N, Kawano Y, Kim-Mitsuyama S, Kimura G, Kohara K, Komuro I, Kumagai H, Matsuura H, Miura K, Morishita R, Naruse M, Node K, Ohya Y, Rakugi H, Saito I, Saitoh S, Shimada K, Shimosawa T, Suzuki H, Tamura K, Tanahashi N, Tsuchihashi T, Uchiyama M, Ueda S, Umemura S. Japanese Society of Hypertension Committee for Guidelines for the Management of Hypertension. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2014). Hypertens Res. 2014; 37:253–390.
19. Chiang CE, Wang TD, Ueng KC, Lin TH, Yeh HI, Chen CY, Wu YJ, Tsai WC, Chao TH, Chen CH, Chu PH, Chao CL, Liu PY, Sung SH, Cheng HM, Wang KL, Li YH, Chiang FT, Chen JH, Chen WJ, Yeh SJ, Lin SJ. 2015 guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension. J Chin Med Assoc. 2015; 78:1–47.
Article
20. The Korean Society of Hypertension. Hypertension management guidelines. Seoul: The Korean Society of Hypertension;2013.
21. Kim JH, Kim DJ, Jang HC, Choi SH. Epidemiology of micro- and macrovascular complications of type 2 diabetes in Korea. Diabetes Metab J. 2011; 35:571–7.
Article
22. Hong KS, Bang OY, Kang DW, Yu KH, Bae HJ, Lee JS, Heo JH, Kwon SU, Oh CW, Lee BC, Kim JS, Yoon BW. Stroke statistics in Korea: part I. Epidemiology and risk factors: a report from the Korean Stroke Society and Clinical Research Center for Stroke. J Stroke. 2013; 15:2–20.
Article
23. Hong JS, Kang HC, Lee SH, Kim J. Long-term trend in the incidence of acute myocardial infarction in Korea: 1997–2007. Korean Circ J. 2009; 39:467–76.
Article
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