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Journals / Klinik Tıp Bilimleri / 2026 / Cilt: 5 Sayı: 4

Treatment Principles for Hypertension and Hyperlipidaemia in Patients with Diabetes Mellitus

Diabetes Mellitus’ta Hiperlipidemi ve Hipertansiyon Tedavi İlkeleri

Dr. Fatma Ela Keskin
Pages
1–4
Publication Date
2017-04-10
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Considering all these data, the treatment of hypertension and hyperlipidaemia in diabetic patients should begin earlier in in the light of guidelines and should be followed strictly.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Abstract Cardiovascular mortality and morbidity has been found to be 2 to 4 fold increased among Type 1 and Type 2 diabetic patients compared with non-diabetic population.
📊
Key Findings & Data:Diabetes also increases the affect of independent risk factors like smoking and hyperlipidaemia.
💡
Conclusion & Impact:Considering all these data, the treatment of hypertension and hyperlipidaemia in diabetic patients should begin earlier in in the light of guidelines and should be followed strictly.
🔬Design:Derleme
📍Scope:Comprehensive Sample
⚙️Variables:diyabet · hipertansiyon · hiperlipidemi

Abstract

Abstract Cardiovascular mortality and morbidity has been found to be 2 to 4 fold increased among Type 1 and Type 2 diabetic patients compared with non-diabetic population. Tre-atment of hypertension in early period of disease is very important to prevent the patients from cardiovascular events, the progression of renal disease and diabetic retinopathy.In recent years diabetes has been defined as “coronary risk equivalent” in various studies. Small and low-density LDL particles which are more found in diabetic patients havemuch more risk in improving coronary artery diseases. Diabetes also increases the affect of independent risk factors like smoking and hyperlipidaemia. Considering all these data, the treatment of hypertension and hyperlipidaemia in diabetic patients should begin earlier in in the light of guidelines and should be followed strictly.

Özet

Öz Tip 1 ve Tip 2 Diabet Mellitus (DM) hastalarında kardiyovasküler mortalite ve morbidite diyabet olmayan hasta grubuna oranla 2-4 kat oranında artış gösterir. Diyabetik hastalarda erken evrede hipertansiyon tedavisi kardiyovasküler hastalığı önlemek, renal hastalık progresyonunu ve diyabetik retinopatiyi engellemek amacıyla çok önemlidir. Son yıllarda yapılan pek çok çalışmada diyabet ‘ koroner risk eşdeğeri’ olarak tanımlanmıştır.Diyabet hastalarında daha yüksek oranda bulunan küçük ve yoğun dansiteli LDL partikülleri koroner arter hastalığı gelişimi açısından daha yüksek riske sahiptir. Diyabet aynı zamanda sigara, hiperkolesterolemi gibi diğer bağımsız risk faktörlerinin etkisini artırmaktadır. Bütün bunlar göz önüne alındığında diyabetik hastalardaki hipertansiyon ve hiperlipidemi tedavisi kılavuzlar eşliğinde erken dönemde başlamalı ve sıkı takip edilmelidir.

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Cite This Article

Keskin, D. F. E. (2017). Treatment Principles for Hypertension and Hyperlipidaemia in Patients with Diabetes Mellitus. Klinik Tıp Bilimleri, Cilt: 5 Sayı: 4, 1–4. https://ajindex.com/articles/1594873

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References (51)

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  27. KDIGO. Chapter 1: Definition and classification of CKD. Kidney IntSuppl2013
  28. http://www.kdigo.org/clinical_practice_guidelines/pdf/CKD/KDIGO_2012_CKD_GL.pdf (Accessed on March 04, 2013). 3.Parving HH, Hommel E, Mathiesen E, et al. Prevalence of micro-albuminuria, arterial hypertension, retinopathy and neuropathy inpatients with insulin dependent diabetes. Br Med J (Clin Res Ed) 1988
  29. Mogensen CE, Hansen KW, Pedersen MM, Christensen CK. Renalfactors influencing blood pressure threshold and choice of treatmentfor hypertension in IDDM. Diabetes Care 1991
  30. 14 Suppl 4:13. 5.Hypertension in Diabetes Study (HDS): I. Prevalence of hyperten-sion in newly presenting type 2 diabetic patients and the associati-on with risk factors for cardiovascular and diabetic complications.J Hypertens 1993
  31. Nosadini R, Sambataro M, Thomaseth K, et al. Role of hyperglycemia and insulin resistance in determining sodium retention in non-insulin-dependent diabetes. Kidney Int 1993
  32. Buse JB, Ginsberg HN, Bakris GL, et al. Primary prevention of car-diovascular diseases in people with diabetes mellitus: a scientific sta-tement from the American Heart Association and the American Dia-betes Association. Circulation 2007
  33. ACCORD Study Group, Cushman WC, Evans GW, et al. Effects ofintensive blood-pressure control in type 2 diabetes mellitus. N EnglJ Med 2010
  34. Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blo-od-pressure lowering and low-dose aspirin in patients with hyper-tension: principal results of the Hypertension Optimal Treatment(HOT) randomised trial. HOT Study Group. Lancet 1998
  35. Howard BV, Roman MJ, Devereux RB, et al. Effect of lower targetsfor blood pressure and LDL cholesterol on atherosclerosis in dia-betes: the SANDS randomized trial. JAMA 2008
  36. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guideli-nes for the management of arterial hypertension: the Task Force forthe management of arterial hypertension of the European Society ofHypertension (ESH) and of the European Society of Cardiology (ESC).J Hypertens 2013
  37. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report ofthe Joint National Committee on Prevention, Detection, Evaluation,and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003
  38. ALLHAT Officers and Coordinators for the ALLHAT Collaborati-ve Research Group. The Antihypertensive and Lipid-Lowering Tre-atment to Prevent Heart Attack Trial. Major outcomes in high-riskhypertensive patients randomized to angiotensin-converting enzymeinhibitor or calcium channel blocker vs diuretic: The Antihyperten-sive and Lipid-Lowering Treatment to Prevent Heart Attack Trial(ALLHAT). JAMA 2002
  39. Alkharouf J, Nalinikumari K, Corry D, Tuck M. Long-term effectsof the angiotensin converting enzyme inhibitor captopril on metabo-lic control in non-insulin-dependent diabetes mellitus. Am J Hyper-tens 1993
  40. Daly CA, Fox KM, Remme WJ, et al. The effect of perindopril on car-diovascular morbidity and mortality in patients with diabetes in theEUROPA study: results from the PERSUADE substudy. Eur HeartJ 2005
  41. Results of the HOPE study and MICRO-HOPE substudy: Effects oframipril on cardiovascular and microvascular outcomes in peoplewith diabetes mellitus: Heart Outcomes Prevention Evaluation StudyInvestigators. Lancet 2000
  42. Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect ofthe angiotensin-receptor antagonist irbesartan in patients with neph-ropathy due to type 2 diabetes. N Engl J Med 2001
  43. Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan onrenal and cardiovascular outcomes in patients with type 2 diabetesand nephropathy. N Engl J Med 2001
  44. Barnett AH, Bain SC, Bouter P, et al. Angiotensin-receptor blocka-de versus converting-enzyme inhibition in type 2 diabetes and neph-ropathy. N Engl J Med 2004
  45. Lindholm LH, Ibsen H, Dahlöf B, et al. Cardiovascular morbidityand mortality in patients with diabetes in the Losartan InterventionFor Endpoint reduction in hypertension study (LIFE): a randomi-sed trial against atenolol. Lancet 2002
  46. ONTARGET Investigators, Yusuf S, Teo KK, et al. Telmisartan, ra-mipril, or both in patients at high risk for vascular events. N Engl JMed 2008
  47. UKPDS 38. UK Prospective Diabetes Study Group: Tight blood pres-sure control and risk of macrovascular and microvascular compli-cations in type 2 diabetes: BMJ 1998
  48. Bakris GL, Fonseca V, Katholi RE, et al. Metabolic effects of car-vedilol vs metoprolol in patients with type 2 diabetes mellitus andhypertension: a randomized controlled trial. JAMA 2004
  49. Gress TW, Nieto FJ, Shahar E, et al. Hypertension and antihyper-tensive therapy as risk factors for type 2 diabetes mellitus. Atherosc-lerosis Risk in Communities Study. N Engl J Med 2000
  50. Jamerson K, Weber MA, Bakris GL, et al. Benazepril plus amlodi-pine or hydrochlorothiazide for hypertension in high-risk patients.N Engl J Med 2008
  51. American Diabetes Association. Dyslipidemia management inadults with diabetes. Diabetes Care 27 (2004) (suppl. 1):68-71. 27.Expert panel on Detection, Evaluation, and Treatmentof High BloodCholesterol in Adults Executive Summary of the Third Report of theNationalCholesterol Education Program (NCEP) Expert Panelon De-tection, Evaluation, and Treatment of High BloodCholesterol in Adults(Adult Treatment Panel III). JAMA (2001) 285: 2486–2497 28.American Diabetes Association. Diabetes mellitus and exercise (Po-sition statement). Diabetes Care (2001) 24:51-55.29.Cholesterol Treatment Trialists’ (CTT) Collaborators Efficacy of cho-lesterol-lowering therapy in 18,686 people with diabetes in 14 ran-domized trials of statins: a meta-analysis. Lancet (2008) 371: 117–125 30.Davidson MH. Rosuvastastin: A highly efficacious statin for the treat-ment of dyslipidemia. Expert Opin. Investig (2002). Drugs 11:125-141. 31.Ridker, Paul M., et al. "Rosuvastatin to prevent vascular events inmen and women with elevated C-reactive protein." New England Jo-urnal of Medicine 359.21 (2008): 2195. 32.Davidson MH. Rosuvastastin: A highly efficacious statin for the tre-atment of dyslipidemia. Expert Opin. Investig. Drugs (2002).11:125-141. 33.de Vries R et al. Plasma cholesteryl ester transfer is a determinantof intima–media thickness in type 2 diabetic and nondiabetic sub-jects: role of CETP and triglycerides. Diabetes. (2005) 54:3554–3559 34.Tavintharan S, Kashyap ML (2001). The benefits of niacin in athe-rosclerosis. Curr. Atheroscler. Rep (2001). 3:74-82. 35.Tsimihodimos V, Miltiadous G, Daskalopoulou SS, Mikhailidis DP,Elisaf MS Fenofibrate: metabolic and pleiotropic effects. Curr. Vasc.Pharmacol. (2005) 3:87-98 36.Cannon CP et al. Vytorin Efficacy International Trial (IMPROVE-IT) Rationale and design of IMPROVE-IT (Improved Reduction ofOutcomes: Vytorin Efficacy International Trial): comparison of eze-timbe/simvastatin versus simvastatin monotherapy on cardiovascu-lar outcomes in patients with acute coronary syndromes. Am HeartJ, in press 37.Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil,omega-3 fatty acids, and cardiovascular disease: AHA scientific sta-tement. Circulation (2002). 106:2747-2757 38.Wilund KR et al. Changes in high-density lipoprotein-cholesterol subf-ractions with exercise training may be dependent on cholesteryl es-ter transfer protein (CETP) genotype. Metabolism. (2002) 51:774–778 39.Van Gaal, Luc F., et al. "Effects of the cannabinoid-1 receptor bloc-ker rimonabant on weight reduction and cardiovascular risk factorsin overweight patients: 1-year experience from the RIO-Europe study."The Lancet 365.9468 (2005): 1389-1397. 40.Prisant LM. Clinical trials and lipid guidelines for type 2 diabetes.J. Clin. Pharmacol (2004). 44:423-430. 41.Wulffele MG, Kooy A, de Zeeuw D, Stehouwer CDA, Gansewoort RT.The effect of metformin on blood pressure, plasma cholesterol andtriglycerides in type 2 diabetes mellitus: a systematic review. J. In-tern. Med (2004). 256:1-14. 42.Winkler K, Freedrich I, Baumstark MW, Wieland H, Marz W (2002).Pioglitazone reduces atherogenic dense low density lipoprotein (LDL)particles in patients with type 2 diabetes mellitus. Br. J. Diabetes Vasc.Dis (2002). 2:143-148. 43.Jones PH. Davidson MH Reporting rate of rhabdomyolysis with fe-nofibrate + statin versus gemfibrozil + any statin. Am. J. Cardiol(2005). 95:120-122. 44.Muhlestein, Joseph B., et al. "The reduction of inflammatory biomar-kers by statin, fibrate, and combination therapy among diabetic pa-tients with mixed dyslipidemia: the DIACOR (Diabetes and Combi-ned Lipid Therapy Regimen) study." Journal of the American Col-lege of Cardiology 48.2 (2006): 396-401. 45.Karas RH et al. Long-term safety and efficacy of a combination ofniacin extended release and simvastatin in patients with dyslipide-mia: the OCEANS study. Am J Cardiovasc Drugs (2008) 8: 69–81