Hypertension and diabetes in special situations and chronic complications: guidelines for clinical practice 2015. Committe on hypertension and other cardiovascular risk factors. Argentine Society of Diabetes

Authors

  • Silvana Alejandra Milrad Manuel Rocca Hospital, Autonomous City of Buenos Aires, Argentina
  • Ángela M. Luongo Pueyrredón Medical Offices, Banfield, Province of Buenos Aires, Argentina
  • Eva López González Vicente López Nutrition and Diabetes Clinic, Province of Buenos Aires, Argentina
  • Alicia Beatriz García Agudos E. Tornú General Hospital, Autonomous City of Buenos Aires, Argentina
  • Solange Houssay Agudos E. Tornú General Hospital, Autonomous City of Buenos Aires, Argentina
  • María Lidia Ruiz Morosini Center for Diabetes and Metabolic Diseases, CODIME, Autonomous City of Buenos Aires, Argentina
  • María Cristina Varela Central Hospital of San Isidro, Dr. Melchor Posse, Province of Buenos Aires, Argentina
  • Alejandro Chertkoff Hospital de Clínicas, Universidad Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina
  • Mabel Ferraro Pedro de Elizalde Children's Hospital, Autonomous City of Buenos Aires, Argentina
  • Blanca Ozuna Juan P. Garrahan Pediatric Hospital, Autonomous City of Buenos Aires, Argentina
  • Liliana Glatstein Provincial Maternal Hospital of Córdoba, Faculty of Medicine Universidad Nacional del Nordeste (UNNE), Entre Ríos, Argentina
  • Natalia Basualdo Anchorena Sanatorium, Reference Center for High Risk Pregnancy (CREAR), Autonomous City of Buenos Aires, Argentina
  • Fabiana Calabria Cardiovascular Institute of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Guillermo Dieuzeide Hospital Nuestra Señora del Carmen Chacabuco, Province of Buenos Aires, Argentina
  • Julieta Méndez Vélez Sarsfield Hospital, Autonomous City of Buenos Aires, Argentina
  • Alicia Elbert Center for Kidney Diseases and Arterial Hypertension, Autonomous City of Buenos Aires, Argentina
  • Alfredo Wassermann Municipal Hospital of Vicente López, Province of Buenos Aires, Argentina
  • Alberto Villamil Cardiovascular Institute of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • <p>Medical Doctor of the Nutrition Division</p> Clinical Hospital of the University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina
  • Mario Saravia Austral University Hospital, Province of Buenos Aires, Argentina
  • Ramiro Sánchez Favaloro Foundation, Autonomous City of Buenos Aires, Argentina
  • Guillermo Burlando Agudos E. Tornú General Hospital, Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v50i1.73

Keywords:

diabetes, hypertension, nephropathy, cardiovascular disease, elderly

Abstract

Introduction: arterial hypertension (AH) and diabetes mellitus (DM) are diseases of high prevalence which are frequently associated.

Objective: to provide useful information and relevant knowledge to support clinical practices that aim at optimizing the diagnosis and offering appropriate therapeutic decisions.

Methodology: these Guidelines for Clinical Practice were created based on the evidence available, large clinical trials published in the last years and adapted diagnostic and therapeutic
resources in our country, The outcomes of our effort resulted in a set of recommendations, focusing on special situations such as pregnancy, childhood, the elderly, and chronic complications.

Conclusions: AH increases the progression and development of chronic micro and macro vascular complications related to DM. The impact of Hypertension treatment is highly significant in reducing morbidity and mortality in people with diabetes, and in the onset and progression of micro and macrovascular complications. In most adults with DM and HA the goal it is to achieve BP
<140/90 mmHg. In more vulnerable elderly, targets are less tight. In people with kidney transplantation, ACR (albumin/creatinine ratio) >300 mg /g, young adults, objectives may be lower (<130-80 mmHg) if achieved without adverse events related to treatment. Avoid DBP <60 mmHg in people over 60 years.
The choice of treatment will depend on age, intolerance or any contraindication and according to the therapeutic target of each chronic complication. The treatment should be early and therapeutic goals should be individualized according to the age, comorbidities and target organ damage.

Author Biographies

Silvana Alejandra Milrad, Manuel Rocca Hospital, Autonomous City of Buenos Aires, Argentina

Diabetologist

Ángela M. Luongo, Pueyrredón Medical Offices, Banfield, Province of Buenos Aires, Argentina

Nutrition Specialist

Eva López González, Vicente López Nutrition and Diabetes Clinic, Province of Buenos Aires, Argentina

Nutrition Specialist and Medical Clinic; Professor attached to Nutrition, University of Buenos Aires (UBA)

Alicia Beatriz García, Agudos E. Tornú General Hospital, Autonomous City of Buenos Aires, Argentina

Plant Doctor

Solange Houssay, Agudos E. Tornú General Hospital, Autonomous City of Buenos Aires, Argentina

Doctor, specialist in Diabetes and Nutrition

María Lidia Ruiz Morosini, Center for Diabetes and Metabolic Diseases, CODIME, Autonomous City of Buenos Aires, Argentina

Family doctor specializing in Diabetes; Medical Director

María Cristina Varela, Central Hospital of San Isidro, Dr. Melchor Posse, Province of Buenos Aires, Argentina

Physician, Nutrition Specialist

Alejandro Chertkoff, Hospital de Clínicas, Universidad Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina

Diabetologist and Nutritionist, Medical Director of the Diabetolgócio Medical Center (CEMEDIAB)

Mabel Ferraro, Pedro de Elizalde Children's Hospital, Autonomous City of Buenos Aires, Argentina

Head of the Nutrition and Diabetes Service, General Hospital for Children Pedro de Elizalde; Deputy Director of the Pediatric Medical Career, University of Buenos Aires (UBA)

Liliana Glatstein, Provincial Maternal Hospital of Córdoba, Faculty of Medicine Universidad Nacional del Nordeste (UNNE), Entre Ríos, Argentina

Former Head of the Medical Clinic Service

Natalia Basualdo, Anchorena Sanatorium, Reference Center for High Risk Pregnancy (CREAR), Autonomous City of Buenos Aires, Argentina

Head of the Tocogynecology Service of the Anchorena Sanatorium; Head of Unit IV of the Sardà Maternity Hospital; Medical Director of the Reference Center for High Risk Pregnancy (CREAR)

Guillermo Dieuzeide, Hospital Nuestra Señora del Carmen Chacabuco, Province of Buenos Aires, Argentina

Endocrinology Specialist; Head of the Endocrinology and Diabetes Service

Julieta Méndez, Vélez Sarsfield Hospital, Autonomous City of Buenos Aires, Argentina

Medical Doctor; Coordinator of the National Program for the Prevention and Control of People with Diabetes Mellitus

Alicia Elbert, Center for Kidney Diseases and Arterial Hypertension, Autonomous City of Buenos Aires, Argentina

Director of the Center

Alfredo Wassermann, Municipal Hospital of Vicente López, Province of Buenos Aires, Argentina

Specialist in Nephrology and Certified in Arterial Hypertension; Medical Director of the Foundation for the Study, Prevention and Treatment of Atherosclerotic Vascular Disease (FEPREVA)

<p>Medical Doctor of the Nutrition Division</p>, Clinical Hospital of the University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina

Medical Doctor of the Nutrition Division

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Published

2023-01-10

How to Cite

Milrad, S. A., Luongo, Ángela M., López González, E., García, A. B., Houssay, S., Ruiz Morosini, M. L., Varela, M. C., Chertkoff, A., Ferraro, M., Ozuna, B., Glatstein, L., Basualdo, N., Calabria, F., Dieuzeide, G., Méndez, J., Elbert, A., Wassermann, A., Villamil, A., Antonucci, R., Saravia, M., Sánchez, R., & Burlando, G. (2023). Hypertension and diabetes in special situations and chronic complications: guidelines for clinical practice 2015. Committe on hypertension and other cardiovascular risk factors. Argentine Society of Diabetes. Journal of the Argentine Society of Diabetes, 50(1), 17–34. https://doi.org/10.47196/diab.v50i1.73

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