By Anthony H. Barnett
Univ. of Birmingham, united kingdom. Pocket-sized guide contains diabetes and vascular sickness, proof base for remedy of high blood pressure in diabetes, analysis and overview, and remedy. Softcover.
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Additional info for Clinical Management of Hypertension in Diabetes: Pocketbook
The mean achieved blood pressures were, respectively, 144/80 (placebo), 141/77 (amlodipine) 140/77 (irbesartan). 006). 003) for doubling of serum creatinine. 07). The all cause mortality was 15–16% in all groups. For the secondary endpoints, irbesartan reduced proteinuria by 33% compared with 6% for amlodipine and 10% for placebo but none of the comparisons were significantly different between the groups. The study was not powered, however, to detect treatment differences between groups for secondary endpoints.
At present these agents are not normally recommended as first-line treatment for hypertension in diabetes, but may be useful in combination with other classes of antihypertensive agents helping to reduce blood pressure and with a neutral metabolic profile. 81 A central component is angiotensin II, a powerful vasoconstrictor and mediator of adrenal aldosterone secretion (Figure 26). It also has an effect on the sympathetic nervous system, particularly on catecholamine release. ACE inhibitors inhibit the conversion of inactive angiotensin I to the active component, angiotensin II.
For most patients, two or more antihypertensive therapies from different classes were required to get down to target blood pressure in the intensively treated group. ” The study included 1500 diabetic patients who were randomly assigned treatment to try and achieve diastolic blood pressures of less than 90, 85, and 80 mm Hg respectively. In addition, half of the patients in each group were randomly allocated aspirin. The group assigned to tightest blood pressure control showed a 50% reduction in cardiovascular endpoints and mortality compared with the group with the least tight control (Figure 21).