Antihypertensive therapy in diabetic patients

Bibliographic Details
Main Author: António, Sandra
Publication Date: 2008
Other Authors: Ferreira, Patrícia, Esteves, Maria Cristina, Cabanelas, Nuno
Format: Article
Language: por
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: https://doi.org/10.32385/rpmgf.v24i3.10510
Summary: Diabetes mellitus and hypertension are clinical entities frequently combined in the same patient; together they exert a synergetic effect that causes, among other events, a fast deterioration of the kidney function and a growing cardiovascular risk. The diabetic patient’s blood pressure must be strictly controlled, aiming at values inferior to 130/80 mmHg. Goals: The analysis of the classes of antihypertensives more frequently recommended for the treatment of the hypertensive diabetic patient. Methods: Bibliographic review, including reference studies and recently published articles on the areas of Diabetology and Hypertension. Conclusions: The first choice antihypertensives should be ACE inhibitors, due to their protective effects on the kidney and the cardiovascular system. In case of intolerance or counter-indication to these antihypertensives, the therapeutic choice should fall on angiotensin II receptor antagonists, which may be combined with low dosage thiazide diuretics. On a second row of the therapeutic arsenal stand b-blockers and calcium channel blockers. Loop diuretics, central agents and a-blockers are third line drugs destined for use in cases of hypertension that resists to the previous classes and/or in specific cases.
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spelling Antihypertensive therapy in diabetic patientsTerapêutica anti-hipertensiva em doentes diabéticosHipertensão ArterialDiabetes MellitusFármacos Anti-hipertensoresHypertensionDiabetes MellitusAntihypertensive DrugsDiabetes mellitus and hypertension are clinical entities frequently combined in the same patient; together they exert a synergetic effect that causes, among other events, a fast deterioration of the kidney function and a growing cardiovascular risk. The diabetic patient’s blood pressure must be strictly controlled, aiming at values inferior to 130/80 mmHg. Goals: The analysis of the classes of antihypertensives more frequently recommended for the treatment of the hypertensive diabetic patient. Methods: Bibliographic review, including reference studies and recently published articles on the areas of Diabetology and Hypertension. Conclusions: The first choice antihypertensives should be ACE inhibitors, due to their protective effects on the kidney and the cardiovascular system. In case of intolerance or counter-indication to these antihypertensives, the therapeutic choice should fall on angiotensin II receptor antagonists, which may be combined with low dosage thiazide diuretics. On a second row of the therapeutic arsenal stand b-blockers and calcium channel blockers. Loop diuretics, central agents and a-blockers are third line drugs destined for use in cases of hypertension that resists to the previous classes and/or in specific cases.Diabetes Mellitus e Hipertensão Arterial são entidades clínicas que se associam frequentemente num mesmo doente; juntas exercem um efeito sinérgico provocando, entre outras, deterioração acelerada da função renal e um aumento do risco cardiovascular. A tensão arterial no doente diabético deve ser rigorosamente controlada de modo a atingir valores inferiores a 130/80 mmHg. Objectivos: Análise das classes farmacológicas de anti-hipertensores mais indicadas no tratamento do diabético hipertenso. Métodos: Revisão bibliográfica incluindo tratados de referência e artigos recentemente publicados nas áreas da Diabetologia e Hipertensão Arterial. Conclusões: Os anti-hipertensores de primeira linha deverão ser os inibidores da enzima de conversão da angiotensina I, devido aos seus efeitos protectores renais e cardiovasculares, ou os antagonistas dos receptores de angiotensina II, caso haja intolerância ou contra-indicação aos primeiros. A estes podem-se associar diuréticos tiazídicos em baixa dose. Numa segunda linha do arsenal terapêutico temos os b-bloqueantes e os bloqueadores dos canais de cálcio. Os diuréticos de ansa, agentes centrais e a-bloqueantes são fármacos de terceira linha a ser empregues face a casos de hipertensão arterial resistente às classes anteriores e/ou em casos específicos.Associação Portuguesa de Medicina Geral e Familiar2008-05-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.32385/rpmgf.v24i3.10510https://doi.org/10.32385/rpmgf.v24i3.10510Portuguese Journal of Family Medicine and General Practice; Vol. 24 No. 3 (2008): Revista Portuguesa de Clínica Geral; 403-9Revista Portuguesa de Medicina Geral e Familiar; Vol. 24 Núm. 3 (2008): Revista Portuguesa de Clínica Geral; 403-9Revista Portuguesa de Medicina Geral e Familiar; Vol. 24 N.º 3 (2008): Revista Portuguesa de Clínica Geral; 403-92182-51812182-517310.32385/rpmgf.v24i3reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPporhttps://rpmgf.pt/ojs/index.php/rpmgf/article/view/10510https://rpmgf.pt/ojs/index.php/rpmgf/article/view/10510/10246António, SandraFerreira, PatríciaEsteves, Maria CristinaCabanelas, Nunoinfo:eu-repo/semantics/openAccess2024-09-17T11:59:00Zoai:ojs.rpmgf.pt:article/10510Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T18:51:22.063772Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Antihypertensive therapy in diabetic patients
Terapêutica anti-hipertensiva em doentes diabéticos
title Antihypertensive therapy in diabetic patients
spellingShingle Antihypertensive therapy in diabetic patients
António, Sandra
Hipertensão Arterial
Diabetes Mellitus
Fármacos Anti-hipertensores
Hypertension
Diabetes Mellitus
Antihypertensive Drugs
title_short Antihypertensive therapy in diabetic patients
title_full Antihypertensive therapy in diabetic patients
title_fullStr Antihypertensive therapy in diabetic patients
title_full_unstemmed Antihypertensive therapy in diabetic patients
title_sort Antihypertensive therapy in diabetic patients
author António, Sandra
author_facet António, Sandra
Ferreira, Patrícia
Esteves, Maria Cristina
Cabanelas, Nuno
author_role author
author2 Ferreira, Patrícia
Esteves, Maria Cristina
Cabanelas, Nuno
author2_role author
author
author
dc.contributor.author.fl_str_mv António, Sandra
Ferreira, Patrícia
Esteves, Maria Cristina
Cabanelas, Nuno
dc.subject.por.fl_str_mv Hipertensão Arterial
Diabetes Mellitus
Fármacos Anti-hipertensores
Hypertension
Diabetes Mellitus
Antihypertensive Drugs
topic Hipertensão Arterial
Diabetes Mellitus
Fármacos Anti-hipertensores
Hypertension
Diabetes Mellitus
Antihypertensive Drugs
description Diabetes mellitus and hypertension are clinical entities frequently combined in the same patient; together they exert a synergetic effect that causes, among other events, a fast deterioration of the kidney function and a growing cardiovascular risk. The diabetic patient’s blood pressure must be strictly controlled, aiming at values inferior to 130/80 mmHg. Goals: The analysis of the classes of antihypertensives more frequently recommended for the treatment of the hypertensive diabetic patient. Methods: Bibliographic review, including reference studies and recently published articles on the areas of Diabetology and Hypertension. Conclusions: The first choice antihypertensives should be ACE inhibitors, due to their protective effects on the kidney and the cardiovascular system. In case of intolerance or counter-indication to these antihypertensives, the therapeutic choice should fall on angiotensin II receptor antagonists, which may be combined with low dosage thiazide diuretics. On a second row of the therapeutic arsenal stand b-blockers and calcium channel blockers. Loop diuretics, central agents and a-blockers are third line drugs destined for use in cases of hypertension that resists to the previous classes and/or in specific cases.
publishDate 2008
dc.date.none.fl_str_mv 2008-05-01
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://doi.org/10.32385/rpmgf.v24i3.10510
https://doi.org/10.32385/rpmgf.v24i3.10510
url https://doi.org/10.32385/rpmgf.v24i3.10510
dc.language.iso.fl_str_mv por
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https://rpmgf.pt/ojs/index.php/rpmgf/article/view/10510/10246
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dc.publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
dc.source.none.fl_str_mv Portuguese Journal of Family Medicine and General Practice; Vol. 24 No. 3 (2008): Revista Portuguesa de Clínica Geral; 403-9
Revista Portuguesa de Medicina Geral e Familiar; Vol. 24 Núm. 3 (2008): Revista Portuguesa de Clínica Geral; 403-9
Revista Portuguesa de Medicina Geral e Familiar; Vol. 24 N.º 3 (2008): Revista Portuguesa de Clínica Geral; 403-9
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