A PRACTICAL GUIDELINE FOR MANAGEMENT OF HYPERTENSION IN PATIENTS WITHDIABETES

Hypertension is common in patients with non-insulin-dependent diabetes mellitus and is also an early sign of diabetic nephropathy in those w ith insulin-dependent diabetes, Hypertension contributes to the progre ssion of both macrovascular disease and nephropathy in patients with d iabetes, Certain antihypertensive agents can adversely affect carbohyd rate and lipid metabolism, Angiotensin-converting enzyme inhibitors an d calcium channel blockers may slow the progression of renal complicat ions in patients with diabetes, The pharmacologic approaches to treatm ent of hypertension in patients with diabetes potentially differ from those in nondiabetic persons, On the basis of a review of the recent l iterature related to antihypertensive therapy for patients with diabet es, we describe an empiric approach to treatment of hypertension in su ch patients, The proposed approach must be modified as new data from r andomized clinical trials become available.