Hypertension in diabetes mellitus

Abstract

Hypertension can be detected very often in patients with diabetes mellitus. In some cases, hypertension develops as a consequence of diabetic nephropathy. Although diabetic nephropathy may occur both in type 1 and in type 2 diabetes, some differences can be observed in the clinical picture according to the type of diabetes. In the majority of patients with type 2 diabetes or prediabetes, the pathomechanism of hypertension can be explained by the concept of the metabolic syndrome. In order to avoid or decrease target organ damage, the goal of antihypertensive treatment in diabetes mellitus is to be set at <130/80 mmHg. The initial antihypertensive therapy is usually based on the evaluation of the global cardiovascular risk. Apart from modifying nutrition and lifestyle, pharmacological treatment with combination of antihypertensive drugs is generally required in order to achieve treatment goal. Diabetic or antidiabetic properties of antihypertensive drugs and antihypertensive characteristics of some antidiabetic drugs should be considered in the everyday clinical practice.