Blood Pressure Control in Type 2 Diabetes Mellitus

Letters16 March 2004Blood Pressure Control in Type 2 Diabetes MellitusSandeep Vijan, MD, MS and Rodney A. Hayward, MDSandeep Vijan, MD, MSFrom Veterans Affairs Health Services Research and Development, Ann Arbor, MI 48113.Search for more papers by this author and Rodney A. Hayward, MDFrom Veterans Affairs Health Services Research and Development, Ann Arbor, MI 48113.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-6-200403160-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Krantz points out that ACE inhibitors may be preferred over ARBs for patients with systolic dysfunction or acute MI. We agree, although trials show no clear statistical differences in outcomes between the 2 drugs. However, we would note that our review was of the primary treatment of hypertension in diabetes, not the treatment of comorbid conditions. Many other situations may lead clinicians to alter the initial choice of agent; for example, in patients with angina pectoris, a β-blocker or a calcium-channel blocker may sometimes be preferred, and for those with prostatic hypertrophy, some clinicians may prefer β-blockers. ...References1. Nielsen FS, Rossing P, Gall MA, Skott P, Smidt UM, Parving HH. Long-term effect of lisinopril and atenolol on kidney function in hypertensive NIDDM subjects with diabetic nephropathy. Diabetes. 1997;46:1182-8. [PMID: 9200654] CrossrefMedlineGoogle Scholar2. Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, et al . Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001;345:851-60. [PMID: 11565517] CrossrefMedlineGoogle Scholar3. Schnack C, Hoffmann W, Hopmeier P, Schernthaner G. Renal and metabolic effects of 1-year treatment with ramipril or atenolol in NIDDM patients with microalbuminuria. Diabetologia. 1996;39:1611-6. [PMID: 8960851] CrossrefMedlineGoogle Scholar4. Lindholm LH, Ibsen H, Dahlof B, Devereux RB, Beevers G, de Faire U, et al . Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002;359:1004-10. [PMID: 11937179] CrossrefMedlineGoogle Scholar5. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. UK Prospective Diabetes Study Group. BMJ. 1998;317:713-20. [PMID: 9732338] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs Health Services Research and Development, Ann Arbor, MI 48113. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Hypertension in Type 2 Diabetes Mellitus: Blood Pressure Goals, Choice of Agents, and Setting Priorities in Diabetes Care Sandeep Vijan and Rodney A. Hayward Blood Pressure Control in Type 2 Diabetes Mellitus Mori J. Krantz Metrics 16 March 2004Volume 140, Issue 6Page: 487-488KeywordsACE inhibitorsBenign prostatic hyperplasiaBlood pressureDrug regulationDrugsHypertensionLeft ventricular hypertrophyProspective studiesRenal diseasesType 2 diabetes ePublished: 16 March 2004 Issue Published: 16 March 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...