Hypertension and the Older Diabetic
Section snippets
Treatment of elderly diabetics with hypertension
Because elderly diabetics with hypertension are at a very high risk for developing fatal and nonfatal coronary heart disease, fatal stroke and nonfatal stroke or transient cerebral ischemic attack, peripheral arterial disease, congestive heart failure, nephropathy, left ventricular hypertrophy, and other target organ damage, these patients should have intensive treatment of modifiable risk factors. Cigarette smoking must be stopped, with a smoking cessation program instituted if necessary (Box 1
Antihypertensive studies in diabetics
Patients with diabetes mellitus or with chronic renal insufficiency, which may be present in diabetics, should have their blood pressure reduced to less than 130/80 mm Hg [37], [38], [54], [62]. Often, multiple antihypertensive drugs will be required to meet this goal [38], [54], [63], [64], [65].
In the United Kingdom Prospective Diabetes Study, 1,148 diabetics with hypertension and a mean age 56 years, were randomized to treatment with atenolol or captopril (see Box 2) [47]. At the 8.4-year
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