September 1984

Special Problems in Treatment of Hypertension in the Patient With Diabetes Mellitus

Author Affiliations

From the Division of Diabetes and Clinical Nutrition, Department of Medicine, University of Southern California School of Medicine, Los Angeles.

Arch Intern Med. 1984;144(9):1829-1831. doi:10.1001/archinte.1984.00350210155026

Hypertension is extremely common in diabetic patients and is two to three times more prevalent than in the normal population. Its presence adds a new dimension to the treatment of both of these chronic diseases. Even though many therapeutic agents may adequately control the BP in diabetic patients, it is essential to be aware of the antihypertensive agent's role in affecting the diabetic state and its complications, and of the drug's potential to cause new complications.1,2 The aim of this report is to emphasize some of the potential problems in managing hypertension in the diabetic patient and to present a rational approach to the treatment of elevated BP in these patients.

PREVALENCE OF HYPERTENSION IN THE DIABETIC PATIENT  Table 1 shows the prevalence of hypertension in a large, multiracial diabetic clinic. In black men and women, the prevalence of hypertension (63%) is two to three times that found in

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