#4389 CONSENSUS STATEMENTS FROM THE DIABETOLOGISTS AND ENDOCRINOLOGISTS ALLIANCE FOR THE MANAGEMENT OF PEOPLE WITH HYPERTENSION AND TYPE 2 DIABETES MELLITUS

Abstract

Abstract Background and Aims Hypertension and type 2 diabetes mellitus (T2DM) are important, intertwined issues in public health. People with both conditions face significantly elevated risks of complications, particularly albuminuria, which is an independent risk factor for cardiovascular (CV) events, kidney failure and all-cause mortality, and thus deserves more attention among physicians and patients. The purpose of this study is to describe the development of recommendations for the management of hypertension and T2DM by a multidisciplinary expert panel. Method The panel included eight specialists (three cardiologists, three endocrinologists and two nephrologists) experienced treating patients with hypertension or T2DM. The panel reviewed clinical trials, meta-analyses, observational studies and clinical guidelines that were obtained by searching PubMed for the publication period from January 2015 to June 2021, to address five discussion areas: (i) blood pressure (BP) targets based on CV/renal benefits; (ii) management of isolated systolic or diastolic hypertension; (iii) roles of angiotensin II receptor blockers (ARBs); (iv) implications of albuminuria for CV/renal events and treatment choices; and (v) roles and tools of screening for microalbuminuria. The panel held three virtual meetings using a modified Delphi method to discuss the literature and their experience regarding the discussion areas. After each meeting, consensus statements were derived and anonymously voted on by every panelist. A consensus statement was accepted only if ≥ 80% of the panelists selected ‘accept completely’ or ‘accept with some reservation’. Results A total of 17 consensus statements were formulated. Conclusion The key messages include: (i) home BP is considered as important as office BP in treatment decision-making; (ii) in patients with T2DM and hypertension on antihypertensive drug treatment, the targets should be < 130/80 mmHg for office BP and < 125/75 mmHg for home BP; (iii) albuminuria is an important therapeutic goal and should be screened for regularly in people with T2DM or hypertension; and (iv) an ARB with proven cardioprotective and renoprotective effects is the preferred drug treatment for patients with T2DM and hypertension.