NATIONAL-HIGH-BLOOD-PRESSURE-EDUCATION-PROGRAM WORKING GROUP-REPORT ON HYPERTENSION IN DIABETES

Hypertension and diabetes mellitus are interrelated diseases that, if untreated, strongly predispose to atherosclerotic cardiovascular disea se and renal disease. More than 3 million Americans have both hyperten sion and diabetes, which are particularly prevalent in the socioeconom ically disadvantaged. Hypertension contributes substantially to morbid ity and mortality in people with diabetes. This report is an update of the 1987 working group report on hypertension and diabetes and includ es important new information on the management of hypertension in peop le with diabetes. Although treatment of hypertension in most people wi th diabetes does not differ from that in people who do not have diabet es, this report outlines some special considerations relevant to the p resence of both diseases. Lifestyle modification is considered as an i nitial treatment modality or as an adjunct to pharmacologic measures. This report also includes a discussion of the treatment of hypertensio n and diabetes in children, an expanded review of sexual dysfunction, and an increased emphasis on the effect of hypertension and diabetes o n target organs. A treatment algorithm represents a practical guidelin e for the physician. Since the previous report, there has been an incr eased awareness, through clinical trials and pharmacologic research, o f the importance of flexibility in the use of antihypertensive drugs a s well as a refinement of nonpharmacologic approaches in treating peop le with both hypertension and diabetes.