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
Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET), 1998
Study design
- Open label, randomized trial
- 380 hypertensive diabetics patient
- Fosinopril (20 mg/day) or amlodipine (10 mg/day)
- Follow up 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.
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 [1].