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Blood pressure monitoring in diabetic paients with ischemic heart disease


Authors: J. Špinar 1;  J. Vítovec 2
Authors‘ workplace: Interní kardiologická klinika FN Brno-Bohunice 1;  I. interní kardioangiologická klinika FN u sv. Anny a LF MU, Brno 2
Published in: Kardiol Rev Int Med 2010, 12(3): 128-130

Overview

We provide an overview of opinions regarding the target blood pressure values in European and American guidelines over the last 25 years. However, subanalysis of the INVEST study and the results of the ACCORD and ABCD studies suggest that tight monitoring of blood pressure is not required and that a suitable blood pressure for diabetic patients ranges from 130 to 139 mmHg with the need to monitor diastolic blood pressure that should not fall below 70 mmHg. Consequently, pharmacological treatment of high normal pressure is not substantiated, although this does not affect the recommendation that each diabetic should take ACE inhibitors to prevent complications.

Keywords:
diabetes mellitus – hypertension – ACE inhibitors


Sources

1. Mancia G, De Backer G, Dominiczak A et al. Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–1187.

2. Widimský J jr., Cífková R, Špinar J et al. Doporučení diagnostických a léčebných postupů u arteriální hypertenze – verze 2007. Doporučení České společnosti pro hypertenzi. Cor Vasa 2008; 50: K3–K16.

3. Widimský J jr., Cífková R, Špinar J et al. Doporučení diagnostických a léčebných postupů u arteriální hypertenze – verze 2007. Doporučení České společnosti pro hypertenzi. Vnitř Lék 2008; 54: 101–118.

4. Mancia G, Laurent S, Agabiti-Rosei L et al. European Society of Hypertension. Reappraisal of European Guidelines on Hypertension Management: a European Society of Hypertension Task Force Document. J Hypertens 2009; 27: 2121–2158.

5. Špinar J, Souček M. Přehodnocení doporučení pro diagnostiku a léčbu hypertenze. Vnitř Lék 2010; 56: 157–161.

6. Cooper-DeHoff RM, Gong Y, Handberg EM et al. Tight Blood Pressure Control and Cardiovascular Outcomes Among Hypertensive Patients with Diabetes and Coronary Artery Disease. JAMA 2010; 304: 61–68.

7. Cushman WC, Evans GW, Byington RP et al. ACCORD Study Group. Effects of Intensive Blood Pressure Control in Type 2 Diabetes Mellitus. N Engl J Med 2010; 362: 1575–1585.

8. Estacio RO, Jeffers BW, Gittford N et al. Effect of Blood Pressure Control on Diabetic Microvascular Complications in Patients with Hypertension and Type 2 Diabetes. Diabetes Care 2000; 23(Suppl 2): 854–864.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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