Skip to main content

The Diabetic Hypertensive (or Hypertensive Diabetic) - A Compelling Need to Optimize Blood Pressure

  • Chapter
Diabetes and Cardiovascular Disease

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 498))

  • 331 Accesses

Abstract

In North America and other parts of the developed world, obesity is increasingly common and is associated with the pathophysiology of both hypertension and diabetes. Both the prevalence of Type 2 diabetes mellitus and the prevalence of hypertension are expected to increase substantially in the first two decades of the next century as aging Baby Boomers enter the ranks of senior citizens. Worldwide, the demographic trends of increasing urbanization, weight gain, increasing blood pressure and increasing prevalence of diabetes mellitus that mimic current Western cardiovascular risk profiles will also create a major public health problem of unprecedented proportions in developing countries. The preeminence of cardiovascular diseases as the leading international cause of mortality that was anticipated in the early years of the third millennium is already a reality at the end of the 1990s.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Johnson KC, Graney MJ, Applegate WB et al Prevalence of undiagnosed non-insulin dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension. J Am Geriatr Soc 1997; 45:695–700.

    PubMed  CAS  Google Scholar 

  2. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. JAMA 1979;241:2035–939.

    Article  PubMed  CAS  Google Scholar 

  3. Wang SL, Head J, Stevens L, Fuller JH. Excess mortality and its relation to hypertension and proteinuria in diabetic patients. The WHO Multinational Study of Vascular Disease in Diabetes. Diabetes Care 1996;19:305–12.

    Article  PubMed  CAS  Google Scholar 

  4. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997; 157:241–346. [Erratum, Arch Intern Med 1998;158:573.]

    Google Scholar 

  5. Curb JD, Pressel SL, Cutler JA et al Effective diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertensive. Systolic Hypertension in the Elderly Program Cooperative Research Group JAMA 1996; 276:1886–1892 Comment in ACP J Club 1997 126 (3):57.

    Google Scholar 

  6. Staessen JA, Thijs L,Gasowski J et al. Treatment of isolated systolic hypertension in the elderly: Further evidence from the systolic hypertension in Europe (SYST-EUR) trial. Am J Cardiol 1998; 82(9B): 20R–22R.

    Article  PubMed  CAS  Google Scholar 

  7. Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood pressure lowering and low dose aspirin in patients with hypertension: Principal results of the Hypertension Optimal Treatment (HOT) randomized trial. HOT Study Group. Lancet 1998; 351: 1755–62.

    Article  PubMed  CAS  Google Scholar 

  8. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in Type 2 diabetes: UKPDS 38. BMJ 1998; 317: 703–713.

    Article  Google Scholar 

  9. UK Prospective Diabetes Study Group. Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: UKPDS 40. BMJ 1998;317:720–6

    Article  Google Scholar 

  10. Tuomilehto J, Rastenyte D, Birkenhager WH et al. Effects of calcium-channel blockade in older patients with diabetes and systolic hypertension. NEJM 1999; 340:677–84.

    Article  PubMed  CAS  Google Scholar 

  11. Hansson L, Lindholm LH, Niskanen L, Lanke J et al. Effect of angiotension-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet 1999;353:611–6.

    Article  PubMed  CAS  Google Scholar 

  12. Hansson L, Lindholm LH, Ekbom T, Dahlof B et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet 1999;354:1751–6

    Article  PubMed  CAS  Google Scholar 

  13. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on death from cardiovascular causes, myocardial infarction, and stroke in high risk patients. NEJM 2000; (to be published January 20, 2000)

    Google Scholar 

  14. Mathiesen ER, Hommel E, Giese J, Parving HH. Efficacy of captopril in postponing nephropathy in normotensive insulin dependent diabetic patients with microalbuminuria. BMJ 1991;303:81–7.

    Article  PubMed  CAS  Google Scholar 

  15. Bjorck S, Mulec H, Johnsen SA, Norden G et al. Renal protective effect of enalapril in diabetic nephropathy. BMJ 1992;304:339–43.

    Article  PubMed  CAS  Google Scholar 

  16. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotension-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med 1993;329:1456–62.

    Article  PubMed  CAS  Google Scholar 

  17. Tatti P, Pahor M, Byington RB et al. Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998; 21:597–603.

    Article  PubMed  CAS  Google Scholar 

  18. Estacio RO, Jeffers BW, Hiatt WR et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes inpatients with non-insulin-dependent diabetes and hypertension. NEJM 1998; 338:645–52.

    Article  PubMed  CAS  Google Scholar 

  19. Malmberg K, Ryden L, Wedel H. Calcium antagonists, appropriate therapy for diabetic patients with hypertension? Eur Heart J 1998; 19:1269–72.

    Article  PubMed  CAS  Google Scholar 

  20. Dengel DR, Galecki AT, Hagberg TM et al. The independent and combined effects of weight loss and aerobic exercise on blood pressure and oral glucose tolerance in older men. Am J Hypertens 1998; 11;1405–12.

    Article  PubMed  CAS  Google Scholar 

  21. Feldman RD, Campbell N, Larochelle P Bolli et al. 1999 Canadian recommendations for the management of hypertension. CMAJ 1999;161:S1–S17.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer Science+Business Media New York

About this chapter

Cite this chapter

Carruthers, S.G. (2001). The Diabetic Hypertensive (or Hypertensive Diabetic) - A Compelling Need to Optimize Blood Pressure. In: Angel, A., Dhalla, N., Pierce, G., Singal, P. (eds) Diabetes and Cardiovascular Disease. Advances in Experimental Medicine and Biology, vol 498. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1321-6_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-1321-6_16

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5496-3

  • Online ISBN: 978-1-4615-1321-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics