Management of Hypertension in Diabetes Mellitus

Abstract

Diabetes mellitus is a progressive metabolic disease with severe macrovascular (coronary artery disease, heart failure, stroke, peripheral artery disease) and microvascular (nephropathy, retinopathy) complications. Diabetes mellitus is associated with a two-fold to three-fold increased risk for cardiovascular events and is the leading cause of chronic kidney disease with almost half of end-stage renal disease cases being attributed to diabetes [1, 2]. The prevalence of type 2 diabetes mellitus increased dramatically during the last decades reaching epidemic dimensions, with even more disappointing projections for the near future [3, 4]. This increase in incidence around most of the world is primarily due to the increase in global obesity. The findings of two recent studies generate even greater concerns. The incidence of both type 1 and type 2 diabetes increased significantly among youths in the US during the last decade, especially in minority populations [5]. Moreover, a large Swedish Registry revealed that although mortality and cardiovascular morbidity declined significantly during the last decade, fatal outcomes declined significantly less in diabetic compared to control individuals [6].