Hypertension is a major risk factor for cardiovascular disease (CVD). It substantially increases the risk for coronary heart disease (CHD), stroke and nephropathy. There is a positive association between hypertension and insulin resistance and the evidence of a causal link is growing. When hypertension coexists with diabetes, which it commonly does, the risk of stroke or CVD is doubled and the risk for developing end stage renal disease increases to 5–6 times compared to hypertensive patients without diabetes. In this chapter we discuss the interaction of hypertension, insulin resistance and other CVD risk factors in the context of the metabolic syndrome, emphasizing the unique aspects of hypertension in patients with diabetes. Therapy for hypertension is discussed in the light of the major prospective trials available to-date, such as the HOPE and RENAAL studies.
KeywordsAngiotensin Converting Enzyme Inhibitor United Kingdom Prospective Diabetes Study Salt Sensitivity Dihydropyridine Calcium Channel Blocker Bilateral Renal Artery Stenosis
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