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Antihypertensive Agents in Diabetic Patients

Antihypertensive Agents in Diabetic Patients EDITORIAL Great Benefits, Special Risks HE BEST APPROACH for the treatment of hy- ing normal serum potassium levels, it is often difficult to pertension in diabetic patients is a subject keep potassium levels in the normal range, even with ag- gressive replacement. of much debate. However, data from a va- Another critical issue not addressed in the present investigation is magnesium depletion, more riety of studies, including the Hypertension T difficult to measure than potassium depletion but well known Optimal Treatment (HOT) study, Syst-Eur to occur with thiazide diuretics. Glucosuria, common in trial, and the Symbolic Hypertension in the Elderly Pro- patients with diabetes, causes magnesium depletion, which gram (SHEP), show that the treatment of hypertension in also contributes to insulin resistance, vasoconstriction, and diabetic patients lowers cardiovascular mortality and events thrombosis. Finally, there have been reports of diuretic to a greater extent than in the nondiabetic population. More- therapy increasing the risk of death in patients with diabe- over, results from the UK Prospective Diabetes Study tes, which may be more significant at doses above 25 mg/d (UKPDS) trial showed a 37% reduction in microvascular of hydrochlorothiazide. end points, with differences in systolic and diastolic blood pressure of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Antihypertensive Agents in Diabetic Patients

JAMA Internal Medicine , Volume 159 (6) – Mar 22, 1999

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References (23)

Publisher
American Medical Association
Copyright
Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinte.159.6.541
Publisher site
See Article on Publisher Site

Abstract

EDITORIAL Great Benefits, Special Risks HE BEST APPROACH for the treatment of hy- ing normal serum potassium levels, it is often difficult to pertension in diabetic patients is a subject keep potassium levels in the normal range, even with ag- gressive replacement. of much debate. However, data from a va- Another critical issue not addressed in the present investigation is magnesium depletion, more riety of studies, including the Hypertension T difficult to measure than potassium depletion but well known Optimal Treatment (HOT) study, Syst-Eur to occur with thiazide diuretics. Glucosuria, common in trial, and the Symbolic Hypertension in the Elderly Pro- patients with diabetes, causes magnesium depletion, which gram (SHEP), show that the treatment of hypertension in also contributes to insulin resistance, vasoconstriction, and diabetic patients lowers cardiovascular mortality and events thrombosis. Finally, there have been reports of diuretic to a greater extent than in the nondiabetic population. More- therapy increasing the risk of death in patients with diabe- over, results from the UK Prospective Diabetes Study tes, which may be more significant at doses above 25 mg/d (UKPDS) trial showed a 37% reduction in microvascular of hydrochlorothiazide. end points, with differences in systolic and diastolic blood pressure of

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Mar 22, 1999

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