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
DOI:
https://doi.org/10.47196/diab.v50i1.73Keywords:
diabetes, hypertension, nephropathy, cardiovascular disease, elderlyAbstract
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.
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