The IDF Conference on blood pressure control in people with diabetes to list a debate program, theme is whether blood pressure lowering in the better? Finally, many experts believe that, in patients with diabetes mellitus blood pressure control in 140/80mmHg, more appropriate.
In order to strengthen the management of hypertension in patients with diabetes prevention and management of diabetes, realize multiple risk control, Chinese Medical Association endocrine credits will have also recently organized experts to develop the " consensus " in Chinese diabetic patients blood pressure management.
Target blood pressure control
Blood pressure control in patients with diabetes mellitus < 130/80 mmHg, combined with renal injury and proteinuria > 1 g/d, blood pressure should be less than 125/75 mmHg. Buck target must follow the principle of individualization in order to ensure the safety, especially for elderly patients.
Treatment scheme
Non drug therapy and drug therapy. Non drug therapy including weight control, diet ( especially salt restriction ), proper exercise, psychological treatment and quit alcohol limit.
Antihypertensive drug therapy include the following.
1 renin angiotensin aldosterone ( RAS ) blocking agents
Recommend angiotensin-converting enzyme inhibitor ( ACEI ) and angiotensinⅡreceptor blocker ( ARB ) for diabetes with hypertension of initial antihypertensive drug or medication, but not recommended two were combined with. In the application of ACEI or ARB on the basis of diuretics, calcium channel blockers ( CCB ) and βreceptor blocker combined with proper.
Diuretics in 2
Thiazide diuretics as patients with diabetes combined antihypertensive treatment options medication. Diabetes mellitus hypertension, high capacity of sodium and water retention and heart failure combined with a small amount of thiazide diuretics, on diabetes patients complicated with heart failure, severe edema may be appropriate to select loop diuretics, such as furosemide; as a combination, it is suggested that the application of low dose diuretics hydrochlorothiazide or Yindapa amine drugs.
3 calcium channel blockers
CCB can be used as diabetic hypertensive patients can choose the combination antihypertensive drugs, especially for diabetes complicated with coronary heart disease, angina or previous myocardial infarction, may serve as the initial medication. CCB can reduce urinary protein, and ACEI or ARB combined effect is better.
4 adrenergic receptor blocker
For patients with diabetes and hypertension, should not be non-selective beta-blockers as drugs of choice; for younger, faster heart rate,βreceptor Gao Min state, no other complications of diabetic hypertensive patients with myocardial infarction or angina and chronic heart failure may be appropriate.
5 receptor blockers
Not recommended for routine use in diabetic hypertensive patients, only for severe or refractory hypertension complicated with heart failure and ( or ), diabetes, and patients with primary aldosteronism, in other antihypertensive drugs can effectively control the blood pressure or patients cannot tolerate the selection.
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