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Chapter-021 Diabetes and Hypertension

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Menon Arun S
2. Shenoy Mohan T
3. Kumar Harish
ISBN
9789351526476
DOI
10.5005/jp/books/12535_28
Edition
2/e
Publishing Year
2015
Pages
5
Author Affiliations
1. Amrita Institute of Medical Sciences, Kochi 682 041, Kerala, India, Amrita Institute of Medical Science, Kochi, Kerala, India
2. Amrita Institute of Medical Science, Kochi, Kerala, India
3. Amrita Institute of Medical Science, Kochi, Kerala, India, IMNCI Project, WHO India Country Office, New Delhi
Chapter keywords
Diabetes mellitus, hypertension, hyperinsulinemia, fundoscopic examination, antihypertensive agents, ACE inhibitor, angiotensin receptor blocker, microalbuminuria

Abstract

Diabetes mellitus and hypertension are the most important causes for cardiovascular disease and stroke. Endothelial dysfunction plays a major role in the development of hypertension in diabetes. Central adiposity, insulin resistance and hyperinsulinemia are also associated with hypertension. Monitoring of BP, fundoscopic examination, thyroid examination and investigation of electrolytes, calcium and urine helps to diagnose the patient with both hypertension and diabetes. The early treatment of hypertension can assist in prevention of diabetic nephropathy and retinopathy. Multiple trials such as UK prospective diabetes study (UKPDS), action to control cardiovascular risk in diabetes (ACCORD) trial and hypertension optimal treatment trials has proved the benefit of treating hypertension in diabetes. The antihypertensive agent includes ACE inhibitor and angiotensin receptor blockers are recommended for patients with diabetes because it has the ability to prevent or delay diabetic-related complications. The diabetic patients with angina, coronary artery disease, myocardial infarction or heart failure can be treated by β-blockers which are very effective antihypertensive agents.

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