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Primary Care-Based Investigation of the Effect of Sitagliptin on Blood Pressure in Hypertensive Patients With Type 2 Diabetes.基于初级保健的西他列汀对2型糖尿病高血压患者血压影响的研究
J Clin Med Res. 2017 Mar;9(3):188-192. doi: 10.14740/jocmr2820w. Epub 2017 Jan 25.
2
Educational strategies for the prevention of diabetes, hypertension, and obesity.预防糖尿病、高血压和肥胖症的教育策略。
Rev Assoc Med Bras (1992). 2016 Nov;62(8):800-808. doi: 10.1590/1806-9282.62.08.800.
3
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.司美格鲁肽与 2 型糖尿病患者的心血管结局
N Engl J Med. 2016 Nov 10;375(19):1834-1844. doi: 10.1056/NEJMoa1607141. Epub 2016 Sep 15.
4
Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors and Cardiovascular Disease: A Systematic Review.钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂与心血管疾病:一项系统评价
Cardiol Ther. 2016 Dec;5(2):161-168. doi: 10.1007/s40119-016-0069-z. Epub 2016 Aug 18.
5
Blood pressure and complications in individuals with type 2 diabetes and no previous cardiovascular disease: national population based cohort study.2型糖尿病且无既往心血管疾病患者的血压与并发症:基于全国人群的队列研究
BMJ. 2016 Aug 4;354:i4070. doi: 10.1136/bmj.i4070.
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Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes.利拉鲁肽与2型糖尿病患者的心血管结局
N Engl J Med. 2016 Jul 28;375(4):311-22. doi: 10.1056/NEJMoa1603827. Epub 2016 Jun 13.
7
Angiotensin receptor blockers (ARB) outperform angiotensin-converting enzyme (ACE) inhibitors on ischemic stroke prevention in patients with hypertension and diabetes - A real-world population study in Taiwan.血管紧张素受体阻滞剂(ARB)在预防高血压合并糖尿病患者缺血性卒中方面优于血管紧张素转换酶(ACE)抑制剂——台湾一项真实世界人群研究
Int J Cardiol. 2016 Jul 15;215:114-9. doi: 10.1016/j.ijcard.2016.04.096. Epub 2016 Apr 14.
8
Current and Future Treatment of Hypertension in the SPRINT Era.SPRINT时代高血压的当前及未来治疗
Methodist Debakey Cardiovasc J. 2015 Oct-Dec;11(4):206-13. doi: 10.14797/mdcj-11-4-206.
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Risks associated with permanent discontinuation of blood pressure-lowering medications in patients with type 2 diabetes.2型糖尿病患者永久性停用降压药物相关风险。
J Hypertens. 2016 Apr;34(4):781-7. doi: 10.1097/HJH.0000000000000841.
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Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses.糖尿病患者不同血压水平下降压治疗的效果:系统评价与荟萃分析
BMJ. 2016 Feb 24;352:i717. doi: 10.1136/bmj.i717.

糖尿病患者高血压管理的实用方法

A Practical Approach to Hypertension Management in Diabetes.

作者信息

Shaikh Altamash

机构信息

Department of Endocrinology, Saifee Hospital, Mumbai, India.

出版信息

Diabetes Ther. 2017 Oct;8(5):981-989. doi: 10.1007/s13300-017-0310-3. Epub 2017 Sep 19.

DOI:10.1007/s13300-017-0310-3
PMID:28929319
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5630564/
Abstract

Hypertension is one of the most important comorbidities of diabetes, contributing significantly to death and disability and leads to macrovascular and microvascular complications. When assessing the medical priorities for patients with diabetes, treating hypertension should be a primary consideration. Practical approaches to hypertension in diabetes, including individualized targets are discussed, as per stage and complication of diabetes, according to current studies and guidelines. Angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARBs) are the most effective drugs for treating hypertension in diabetes, in the absence of contraindications. Calcium antagonists or diuretics are acceptable as second-line agents. Once the target is achieved, antihypertensive drugs should be continued. Newer antidiabetes medications such as sodium glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP1-RA), and dipeptidyl peptidase-4 inhibitors (DPP4i) have antihypertensive properties and may assist in treatment decision-making.

摘要

高血压是糖尿病最重要的合并症之一,对死亡和残疾有显著影响,并导致大血管和微血管并发症。在评估糖尿病患者的医疗重点时,治疗高血压应是首要考虑因素。根据当前研究和指南,针对糖尿病不同阶段和并发症,讨论了糖尿病高血压的实用治疗方法,包括个体化目标。在没有禁忌证的情况下,血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体阻滞剂(ARB)是治疗糖尿病高血压最有效的药物。钙拮抗剂或利尿剂可作为二线药物。一旦达到目标,应继续使用抗高血压药物。新型抗糖尿病药物,如钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)、胰高血糖素样肽1受体激动剂(GLP1-RA)和二肽基肽酶4抑制剂(DPP4i)具有降压特性,可能有助于治疗决策。