Sowers J R
Division of Endocrinology, Metabolism and Hypertension, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Am J Cardiol. 1998 Nov 12;82(9B):15R-19R. doi: 10.1016/s0002-9149(98)00751-6.
Macrovascular disease is the major cause of mortality in persons with type 2 diabetes mellitus, and hypertension is an important factor contributing to this high prevalence. High blood pressure is about twice as common in persons with diabetes mellitus as in those without. Up to 75% of diabetes-related cardiovascular complications are attributed to hypertension. These observations are part of the rationale for recommendations for more aggressive lowering of blood pressure (to < 130/85 mm Hg) in persons with coexistent diabetes and hypertension. This may require therapy with a combination of antihypertensive agents. The Fosinopril versus Amlodipine Cardiovascular Events Trial (FACET), discussed herein, supports the case for combination therapy with an angiotensin-converting enzyme (ACE) inhibitor and a calcium antagonist in diabetic patients with hypertension.
大血管疾病是2型糖尿病患者死亡的主要原因，而高血压是导致这种高患病率的一个重要因素。糖尿病患者中高血压的发生率约为非糖尿病患者的两倍。高达75%的糖尿病相关心血管并发症归因于高血压。这些观察结果是建议对合并糖尿病和高血压的患者更积极地降低血压（至<130/85 mmHg）的部分依据。这可能需要联合使用抗高血压药物进行治疗。本文讨论的福辛普利与氨氯地平心血管事件试验（FACET）支持在糖尿病高血压患者中联合使用血管紧张素转换酶（ACE）抑制剂和钙拮抗剂进行治疗。
