NEUROPATHY AND HYPERTENSION IN DIABETES

Diabetes and hypertension are the causes of most end-stage renal disea se (ESRD) in the United States and are also both independent risk fact ors for cardiovascular disease (CVD). When coexistent, they increase t he risk twofold to eightfold for CVD morbidity and more than double it for CVD mortality. If nephropathy is also present, the risk for CVD i s even greater. A number of clinical studies provide strong evidence o f the effectiveness of early detection and aggressive treatment of hyp erglycemia and hypertension in delaying the onset of diabetic nephropa thy and preventing its progression to ESRD. Such intervention is likel y to also impact the prevalence of CVD in diabetic individuals. Strate gies for screening, and treatment of hyperglycemia, hypertension, and other risk factors to prevent nephropathy and cardiovascular disease a re discussed.