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Review
. 2002 Nov-Dec;4(6 Suppl 2):3-10.
doi: 10.1111/j.1524-6175.2002.01886.x.

Update on the management of diabetes and hypertension

Thomas D Giles  1
Affiliations
Review

Update on the management of diabetes and hypertension

Thomas D Giles. J Clin Hypertens (Greenwich). 2002 Nov-Dec.
No abstract available

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Figures

Figure 1
Figure 1
Current and projected prevalence rates for diabetes, worldwide from World Health Organization Statistics, 2000
Figure 2
Figure 2
Role of insulin resistance in the metabolic syndrome Data derived from Deedwania PC. The deadly quartet revisited. Am J Med. 1998;105(1A):1S–3S.
Figure 3
Figure 3
Cardiovascular (CV) risk similar in patients with type 2 diabetes and no prior myocardial infarction (MI) as in nondiabetics with prior MI; *p<0.001 for diabetes vs. no diabetes Data derived from Haffner et al. 3
Figure 4
Figure 4
Association of systolic blood pressure and cardiovascular death in type 2 diabetes Data derived from Stamler et al. 1
Figure 5
Figure 5
Association of microalbuminuria and cardiovascular morbidity and mortality in type 2 diabetes. Microalbuminuria is a strong predictor of all‐cause mortality and cardiovascular (CV) morbidity and mortality in type 2 diabetes. A meta‐analysis of prospective trials of patients with type 2 diabetes found an overall odds ratio of 3.1 for total mortality and 1.8 for CV morbidity and mortality in patients with microproteinuria. The presence of microalbuminuria may reflect a generalized defect in vascular permeability leading to atherogenesis. Hypertension is a major risk factor for the development of microalbuminuria. Data derived from Dinneen and Gerstein. 16
Figure 6
Figure 6
Microalbuminuria and ischemic heart disease risk. The presence of microalbuminuria (24‐hour excretion of between 30 and 300 mg/d of urinary protein) is associated with an increased risk of coronary heart disease at all levels of systolic blood pressure (SBP). (n=2085; 10‐year follow‐up) Data derived from Borch‐Johnsen K, Feldt‐Rasmussen B, Strandgaard S, et al. Urinary albumin excretion. An independent predictor of ischemic heart disease. Arterioscler Thromb Vasc Biol. 1999;19:1992–1997.
Figure 7
Figure 7
Blood pressure (BP) control reduces cardiovascular events: Hypertension Optimal Treatment (HOT) Trial MI=myocardial infarction; CV=cardiovascular Data derived from Hansson et al. 14
Figure 8
Figure 8
Reduction in congestive heart failure risk as a result of tight blood pressure control in patients with type 2 diabetes: UK Prospective Diabetes Study 38 MI=myocardial infarction; HF=heart failure NS=not significant. Data derived from UKPDS Group. 13
Figure 9
Figure 9
Both tight glucose and blood pressure (BP) control reduce cardiovascular outcomes: UK Prospective Diabetes Study (UKPDS) *p<0.05 Tight BP control = 144/82 mm Hg; Tight glucose control = HbA1c = 7.0%. Data derived from UKPDS Group 12, 13
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References

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