Nilsson P
Avdelningen för medicin, Universitetssjukhuset MAS, Malmö.
Lakartidningen. 2000 Feb 9;97(6):568-72.
Tre treatment of hypertension in type 2 diabetes in currently much in focus. The aim of this treatment is to prevent cardiovascular disease by reducing the mean blood pressure level to less than 140/85 mm Hg in all patients who do not experience orthostatic reactions. In most patients it seems as if the strict blood pressure control is more important for the prognosis than the choice made of specific drug therapy. Nevertheless, specific pharmacological properties may be of special importance for some patients. During the last few years several new randomised trials have increased our knowledge for an approach based on evidence-based medicine towards hypertension in type 2 diabetes. These studies are summarized and discussed in this paper. Of particular importance is that normally a combination-therapy is needed in the vast majority of patients. Synergistic drugs should therefore be combined to achieve an optimal blood pressure control with a minimum of side effects.