Hipertensión arterial y diabetes: guías de recomendaciones para la práctica clínica 2015. Comité de hipertensión arterial y otros factores de riesgo cardiovascular. Sociedad Argentina de Diabetes
DOI:
https://doi.org/10.47196/diab.v49i2.201Palabras clave:
diabetes, hipertensión arterial, diagnóstico, tratamientoResumen
Introducción: la hipertensión arterial (HA) y la diabetes mellitus (DM) son enfermedades crónicas de alta prevalencia que se encuentran frecuentemente asociadas.
Objetivos: brindar los conocimientos para la práctica clínica que favorezcan la toma de decisiones diagnósticas y terapéuticas adecuadas, basadas en las evidencias científicas actuales.
Materiales y métodos: utilizando la evidencia disponible, los grandes ensayos clínicos publicados en los últimos cuatro años y la adaptación de los recursos diagnósticos y terapéuticos de nuestro país se elaboraron las presentes “Recomendaciones
para la Práctica Clínica”.
Conclusiones: la HA aumenta la progresión y el desarrollo de las complicaciones crónicas micro y macrovasculares de la DM. El impacto del tratamiento de la HA es significativo en la reducción de la morbimortalidad de las personas con DM. Por ello, el tratamiento debe ser temprano y las metas de objetivo terapéutico deberán ser individualizadas según grupo etario, comorbilidades y daño de órgano blanco. En todas las personas con HA, tengan o no DM y/o enfermedad renal crónica (ERC), el objetivo es alcanzar una PA <140/90 mmHg.
Podrán considerarse objetivos más cercanos a 130/80 mmHg en jóvenes, sin comorbilidades, con larga expectativa de vida y menor tiempo de diagnóstico de DM: en quienes tendrían beneficios a nivel renal o en quienes el riesgo de ACV es sustancial, si se
logran sin efectos adversos asociados al tratamiento. Los IECA o ARA II son los fármacos de primera elección excepto en casos de intolerancia o contraindicación. Un bajo porcentaje de personas
logra el objetivo terapéutico. La educación es una herramienta fundamental para mejorar la adherencia al tratamiento.
Citas
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- Material suplementario en pag Web: http://www.diabetes.org.ar/espacio-para-el-profesional/opiniones-y-recomendaciones/.
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