Control over blood pressure, and not just blood sugar, should be a priority in treating type 2 diabetes, according to latest guidelines from the American College of Physicians (ACP).
Control over blood pressure, and not just blood sugar, should also be a priority in treating type 2 diabetes, according to latest guidelines from the American College of Physicians (ACP).High blood pressure, or hypertension, is a common problem in people with type 2 diabetes, contributing to their elevated risk of heart disease, stroke and early death. In type 2 diabetes mellitus (also called adult-onset diabetes), the body makes enough insulin but is unable to use it normally. The result is high blood sugar levels that, over time, can lead to complications that include blindness, kidney failure, nerve damage, and heart disease. Good care to keep blood sugar under control can prevent the development of these complications. The control of blood pressure also is extremely important in preventing diabetes complications and death.Researchers from the University of Michigan reviewed studies about blood pressure and cardiovascular complications and death in people with type 2 diabetes. They used these studies to identify the benefits of blood pressure control, the ideal blood pressure levels, and the most effective blood pressure drugs in people with this disease.
Studies about the benefits of blood pressure control in type 2 diabetes showed that controlling blood pressure decreases heart disease, stroke, and early death. People with type 2 diabetes do best if their diastolic blood pressure (the second number in blood pressure readings) is less than 80 mm Hg. Systolic blood pressure (the first number in blood pressure readings) should be less than 135 mm Hg. The studies that evaluated the various blood pressure drugs showed that people with type 2 diabetes and high blood pressure do best when they take angiotensin-converting enzyme (ACE) inhibitors and thiazide diuretics. Angiotensin-receptor blockers are a good option in patients who do not tolerate ACE inhibitors. Other types of blood pressure drugs include calcium-channel blockers and beta-blockers. It is important for patients to understand that they will probably need to take more than one medication to adequately control their blood pressure.
Annals of Internal Medicine, April 2003 Vol. 138 (7)
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