Aksnes Tonje A, Skårn Sigrid N, Kjeldsen Sverre E
Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway.
Expert Rev Cardiovasc Ther. 2012 Jun;10(6):727-34. doi: 10.1586/erc.12.59.
Patients with diabetes mellitus have a high risk of cardiovascular disease, and the latter is the leading cause of premature mortality in diabetic patients. Treatment of risk factors and comorbidities, such as hypertension, is very important and may effectively prevent cardiovascular events. The blood pressure goal in diabetic patients should be below 140/90 mmHg, probably down to 130-135/85 mmHg, although the evidence for this is scarce. To reach this blood pressure goal, intensive lifestyle intervention and often combinations of different antihypertensive drugs must be initiated. In combination treatment, a blocker of the renin-angiotensin system should be included, and according to the results of the ACCOMPLISH trial, a combination of a renin-angiotensin system blocker and a calcium channel blocker should probably be the first choice.
糖尿病患者患心血管疾病的风险很高，而心血管疾病是糖尿病患者过早死亡的主要原因。治疗危险因素和合并症，如高血压，非常重要，可能有效预防心血管事件。糖尿病患者的血压目标应低于140/90 mmHg，可能降至130 - 135/85 mmHg，尽管这方面的证据很少。为达到这一血压目标，必须启动强化生活方式干预，通常还需联合使用不同的降压药物。在联合治疗中，应包括肾素 - 血管紧张素系统阻滞剂，根据ACCOMPLISH试验的结果，肾素 - 血管紧张素系统阻滞剂与钙通道阻滞剂的联合可能是首选。
