Diabetes and hypertension: Clinical update

Abstract

The presence of hypertension in individuals with type 2 diabetes augments the risk for cardiovascular morbidity and mortality. In this regard, data support that management of hypertension in this high-risk population is a critical risk reduction strategy. In recent years, a number of work groups have redefined hypertension, management strategies, and targets. In this context, there is still considerable discussion on an appropriate target for blood pressure in the diabetic population. However, despite this discussion on target blood pressure, it is widely recognized that there is considerable residual risk for heightened cardiovascular events in the hypertensive, diabetic population despite widespread awareness and treatment. There has been increasing interest in management strategies for blood pressure reduction in this high-risk population that complement traditional antihypertensive agents. Large-scale clinical trials have shown that hypoglycemic agents can complement blood pressure reduction and have a favorable effect on cardiovascular outcomes such as the sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists. In the diabetic population, consideration should be given to the blood pressure lowering effects of the newer hypoglycemic agents when working toward additional glycémie control in patients with hypertension.