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Hypertension Management in the Diabetes Patient

Spindler Hall/Ferris State University, 1000 Oliver Street, Room 105, Kalamazoo, MI 49008;durst{at}kcms.msu.edu

Deb Schering, PharmD

Kalamazoo Center for Medical Studies,Pfizer, Ferris State University, IBA Health Plans, Blue Care Network, 1000 Oakland Drive, Kalamazoo, MI 49008.

Approximately 11 million of the 17 million US citizens with type 2 diabetes mellitus also have hypertension. The development of diabetic nephropathy in patients with type 1 diabetes is frequently associated with hypertension, and both may present several years after the onset of diabetes. In type 2 diabetes, hypertension may precede the development of diabetes by several years. Differences that exist between type 1 and type 2 diabetes and the development of hypertension may indicate differences in the concomitant disease processes, yet the inevitable development of both diseases contributes to significant increases in risk of cardiovascular disease.The pharmacist must be familiar with blood pressure treatment goals in the hypertensive-diabetic patient and appropriate pharmacotherapeutic management. This article outlines treatment goals in the patient with diabetes and concurrent hypertension, reviews trials assessing pharmacologic treatments, and provides a summary of monitoring parameters to guide the pharmacist in the management of this population.

Key Words: Diabetes • hypertension • ACE inhibitors • ARBs • comorbidities

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