Diabetes with hypertension medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]
Overview
Hypertension is a common co-morbidity associated with patients of diabetes, especially type 2 diabetes. Proper management of both these conditions are important to prevent future chronic complications like cardiovascular, nephrology and other complications.
Supportive trial data
Study name:LIFE study, 2002[1]
- Study design: Double blinded, randomised, parallel-group trial
- Sample size: 1195 patients with diabetes, hypertension, left ventricular hypertrophy (on electrocardiograms)
- Drugs: Losartan or Atenolol
- Study period: 4 years
- Study results: Losartan was found to be more effective than atenolol in reducing composite endpoints like cardiovascular morbidity and all causes mortality in patients with hypertension, diabetes, and left-ventricular hypertrophy.
Study name: Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial, (FACET), 1998 [2]
- Study design: Open label, randomized trial
- Sample size: 380 hypertensive diabetics patient
- Drugs: Fosinopril (20 mg/day) or amlodipine (10 mg/day)
- Study period: 3.5 years
- Inclusion criteria- NIDDM and hypertension (SBP > 140 mmHg or DBP > 90 mmHg).
- Exclusion criteria- History of coronary heart disease or stroke, serum creatinine > 1.5 mg/dl, albuminuria > 40 micrograms/min, and use of lipid-lowering drugs, aspirin, or antihypertensive agents other than beta-blockers or diuretics.
- Study results: Fosinopril lowered the risk of the composite endpoints of acute myocardial infarction, stroke, or hospitalization due to angina more compared to amlodipine (hazards ratio = 0.49, 95% CI = 0.26-0.95). However, no significant difference in total serum cholesterol, HDL cholesterol, HbA1c, fasting serum glucose, or plasma insulin was found.
References
- ↑ Lindholm LH, Ibsen H, Dahlöf B, Devereux RB, Beevers G, de Faire U; et al. (2002). "Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol". Lancet. 359 (9311): 1004–10. doi:10.1016/S0140-6736(02)08090-X. PMID 11937179. Review in: ACP J Club. 2002 Nov-Dec;137(3):87
- ↑ Tatti P, Pahor M, Byington RP, Di Mauro P, Guarisco R, Strollo G; et al. (1998). "Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM". Diabetes Care. 21 (4): 597–603. PMID 9571349.