Review: Implications from hypertension outcome trials for the management of patients with hypertension and diabetes

Abstract

The UKPDS highlighted the importance of blood pressure control in patients with type 2 diabetes. In this review I draw on data from the INSIGHT and other recent outcome trials in hypertension which provide clear evidence that it is the achievement of good control of blood pressure, irrespective of the initial choice of drug, that is the major determinant of outcome. The INSIGHT trial provides hard evidence of how resistant to treatment patients with diabetes really are. In this review I offer a theoretical and practical solution in the form of a stepwise algorithm using multiple therapies.

Keywords

hypertension diabetes outcome trial guidelines calcium channel blocker diuretic ACE inhibitor angiotensin receptor blocker beta blocker.

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