This is an automatically translated article.
The article was professionally consulted with Doctor Cardiologist - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.
If you have diabetes and hypertension at the same time, in addition to setting blood sugar goals, maintaining blood pressure goals is also important. Depending on your health condition, doctors may not use drugs or use antihypertensive drugs right away. The use of blood pressure medication for people with diabetes will be slightly different than for people without diabetes. So how to use antihypertensive drugs for diabetics, what drugs to use, invite you to the following article.
1. How important is it to treat high blood pressure in people with diabetes?
Diabetes hardens the large blood vessels that carry blood to the body, also known as atherosclerosis. That can cause high blood pressure, and if left untreated, you can end up with complications from diabetes such as heart disease, blood vessel damage, kidney failure.
Effective blood pressure control is an important goal if you have diabetes. The dangers of high blood pressure in diabetes are so severe that the combination of well-controlled blood sugar and well-controlled blood pressure has a dramatic impact on long-term health (quality of life, blood complications, ultimate life expectancy). When you set a blood sugar goal, make sure that maintaining your blood pressure goal is also an essential goal.
2. What should your blood pressure be?
The goal of blood pressure treatment is to lower your blood pressure. How much depends on your risk of cardiovascular disease (CVD). If your doctor feels that risk is high, a blood pressure goal might be 130/80. For patients at lower risk of CVD, the goal might be 140/90.
3. Should antihypertensive drugs be used for diabetics with high blood pressure right away?
According to the hypertension treatment protocol of the Vietnam Cardiology Association, diabetic patients with hypertension of 140/90 mmHg or higher, doctors will consider treatment with non-pharmacological options first.
There are many methods for diabetics that will help cure high blood pressure without using antihypertensive drugs for diabetics such as:
Control blood sugar. Stop smoking. Healthy eating. Exercise most days. Keep your weight at a reasonable level. Don't drink a lot of alcohol. Limit salt intake. Visit your doctor regularly.
4. How to treat with antihypertensive drugs for people with diabetes?
Drug treatment is a necessary step for most people with high blood pressure. The management and treatment of blood pressure medication for people with diabetes is slightly different for people with diabetes.
Current guidelines from the American Diabetes Association (ADA) recommend that anyone with diabetes and a blood pressure of 140/90 mmHg or higher but less than 160/100 should start taking a blood pressure medication. . The choice of blood pressure medication for diabetics can be divided into the following groups:
Antihypertensive drugs for diabetics (without the presence of kidney disease), including drugs called: ACE inhibitors (ACEi) Angiotensin receptor blockers (ARBs) Thiazide diuretics Calcium channel blockers (CCBs) ADA recommends that people with diabetes and kidney disease in this group take the drug ACE inhibitors or angiotensin receptor blockers (ARBs).
Blood pressure medicine for diabetics with blood pressure of 160/100 or higher, can start taking any two drugs from the following three drug classes: ACEi or ARB Thiazide diuretics Calcium channel blockers ADA recommends people People with kidney disease in this blood pressure group should take an ACE inhibitor or an angiotensin receptor blocker, along with a diuretic or calcium channel blocker.
If blood pressure is still difficult to control, a third drug can be added to the list. Regardless of the medication used, lifestyle changes are an important part of treatment.
5. Some commonly used antihypertensive drugs for diabetics
5.1 Diabetic Antihypertensives – ACE Inhibitors An ACE inhibitor (ACEi) is a medication that treats high blood pressure by blocking an enzyme in the body that produces angiotensin II, a substance that causes blood pressure to increase. narrows blood vessels and secretes hormones that raise blood pressure.
In diabetic patients with hypertension ACEi are quite effective because they can prevent or slow microvascular and macrovascular complications caused by diabetes. Furthermore, ACE inhibitors were more effective than other drugs in delaying the onset of renal failure in hypertensive and type 1 diabetic patients with macroalbuminuria.
Therefore, ACEIs are often the first-line blood pressure medication recommended for diabetic patients with hypertension.
5.2 Diabetic Antihypertensives – Angiotensin Receptor Blockers Angiotensin II receptor blockers (ARBs) block the action of angiotensin II. As a result, the medicine allows your veins and arteries to widen (dilate) which lowers your blood pressure and makes it easier for your heart to pump blood.
Like ACEIs, ARBs reduce diabetes complications (eg, progression of kidney disease), they are effective in delaying the onset of renal failure in patients with type 2 diabetes, hypertension and gross albuminuria.
ARBs are also the drug of choice for the control of hypertension in patients with diabetes, or in hypertensive patients who are intolerant of ACE inhibitors.
5.3 Diabetic Antihypertensives – Thiazide diuretics and calcium channel blockers Thiazide diuretics: One of three drugs in the diuretic class designed to increase the excretion of water and salt from the lower body. urine form. Thiazide diuretics are commonly used and especially to treat high blood pressure. Not only do they reduce fluid, but they also make your blood vessels dilate. In the treatment of hypertension in patients with diabetes, thiazide diuretics are used as monotherapy or as part of a combination regimen.
Calcium channel blockers: How they work: Calcium causes your heart and arteries to contract harder. By preventing calcium from entering the cells of the heart and arteries, calcium channel blockers allow blood vessels to relax and open, thereby lowering blood pressure.
Both of these diabetes medications can reduce the risk of cardiovascular events and are effective for people with diabetes with high blood pressure.
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