Guzmán C B, Sowers J R
Division of Endocrinology, Metabolism and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Prog Cardiovasc Dis. 1999 May-Jun;41(6):461-70. doi: 10.1016/s0033-0620(99)70022-8.
Patients with diabetes mellitus have an increased prevalence of hypertension and associated cardiovascular disease (CVD), including coronary and cerebrovascular disease. The risk of an individual of developing CVD is much greater when both diseases coexist and is further magnified by their frequent association with dyslipidemia, coagulation, platelet, and endothelial abnormalities. Metabolic abnormalities frequently associated with hypertension are insulin resistance, enhanced coagulation, and decreased fibrinolytic activity. Drug treatment of hypertension in diabetic subjects is fraught with potential difficulties, including altered efficacy of medications, possible side effects, worsening of glycemic control, and impairment of lipid metabolism. Because hypertension is a major contributor to morbidity and mortality in diabetes, it should be recognized and treated early and aggressively despite these difficulties. This article reviews the efficacy and side effects of the various classes of antihypertensive agents in patients with diabetes mellitus.
糖尿病患者患高血压及相关心血管疾病（CVD）的患病率增加，包括冠心病和脑血管疾病。当这两种疾病共存时，个体发生心血管疾病的风险要大得多，并且由于它们经常与血脂异常、凝血、血小板和内皮异常相关联，风险会进一步放大。经常与高血压相关的代谢异常包括胰岛素抵抗、凝血增强和纤溶活性降低。糖尿病患者高血压的药物治疗充满潜在困难，包括药物疗效改变、可能的副作用、血糖控制恶化和脂质代谢受损。由于高血压是糖尿病发病和死亡的主要因素，尽管存在这些困难，仍应尽早积极地识别和治疗。本文综述了各类抗高血压药物在糖尿病患者中的疗效和副作用。
