Publication details
Diabetes mellitus a hypertenze
| Title in English | Diabetes mellitus and hypertension |
|---|---|
| Authors | |
| Year of publication | 2010 |
| Type | Article in Periodical |
| Magazine / Source | Postgraduální medicina |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | treatment of hypertension diabetes nellitus |
| Description | Antihypertensive therapy has cardioprotective and nephroprotective effects in patients with type 2 diabetes mellitus. ACE inhibitors, AT1-blockers, which improve insulin sensitivity, are the basis for treatment of hypertensive patients with diabetes. Renin inhibitors are a new drug class. In second line we use calcium channel blockers, particularly of dihydropyridine type, which are metabolically neutral. On the other side beta-blockers and diuretics, particularly thiazide, have metabolically unfavorable effects. It is suitable to choose cardioselective beta-blockers or beta-blockers from the class with associated vasodilatory capacity. Diuretics should be chosen maximally in combination and in small doses, especially potassium-sparing agents or diuretics of the apparently metabolically neutral indapamide type. Given the difficulty of achieving the target BP between 130-139/80-85 mmHg, it is necessary to maximize the use of combination therapy, in which the basis should be AT1-blockers or ACE inhibitors in combination with calcium channel blockers or diuretics. Blood pressure reduction is more important than the choice of antihypertensive drugs itself. |
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