Prof. Guido Grassi
The session "Hypertension and diabetes - deadly challenge" was devoted to an update on the treatment of hypertension in type 2 diabetic patients. Uncomplicated hypertension with diabetes: when and how to treat? Hypertension with diabetic nephropathy: how to manage? Two short presentations followed by two panelist discussions represented the core of the session. Three were the main messages developed. The first one was the blood pressure target for the antihypertensive intervention, with evidence that in order to obtain an effective cardiovascular risk reduction blood pressure should be reduced to values close to 130/80 mmHg. Lower values may be associated with the so called J-curve phenomenon, meaning an increase rather than a reduction of coronary events. The second issue refers to the need to use in diabetic hypertensive patients a two drug combination treatment in order to achieve an effective control of elevated blood pressure values. Finally, the third issue refers to the need to use a drug as a component of the two drug combination regimen acting on the renin-angiotensin system (Ace inhibitor or an angiotensin II receptor blocker) in order to achieve a greater nephroprotection, particularly when microalbuminuria is present. The session ended with a short presentation of the current European Society of Cardiology/European Society of Hypertension Guidelines on hypertension treatment. Guidelines were issued about two years ago and they are expected to be replaced by new guidelines in 2013.
Hypertension and diabetes - deadly challenge
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