Combination Therapy for Hypertension and Renal Disease in Diabetics as Compared to Non-Diabetics

  • George L. Bakris

Abstract

More than 75% of individuals with diabetes, microalbuminuria and hypertension require two or more antihypertensive medications to attain the currently recommended level of arterial pressure control, i.e., <130/80 mmHg [1–3]. To achieve this blood pressure goal, it is common to add a medication whose antihypertensive action potentiates the initially selected drug [4,5]. To further improve compliance and reduce drug side effect profiles, fixed-dose combinations of antihypertensive drugs with complementary modes of action have been recently developed. These medications combine a lower dose of two different antihypertensive drugs that, in a fixed dose combination, reduce arterial pressure to a greater extent than either alone. The history of various fixed-dose antihypertensive drug combinations is shown in table 55-1. The evolution of fixed-dose combination antihypertensive therapy is beyond the scope of this chapter. The reader, however, is referred to a recent review on the topic [5]. This chapter will focus on the available animal and clinical evidence of specific antihypertensive medications, either alone or combined, that have demonstrated efficacy for reducing arterial pressure and slowing the progression of diabetic renal disease. This will primarily, but not exclusively, include the angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers (CCBs).

Keywords

Diabetic Nephropathy Angiotensin Converting Enzyme Angiotensin Converting Enzyme Inhibitor Diabetic Renal Disease Comparable Blood Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • George L. Bakris
    • 1
  1. 1.Rush University Hypertension Center, Rush-Presbyterian-St. Luke’s Medical CenterChicagoUSA

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