Fast Five Quiz: Type 2 Diabetes and Cerebrovascular Disease

Romesh Khardori, MD, PhD, FACP


April 27, 2022

The American College of Cardiology and American Heart Association 2017 hypertension guidelines recommend antihypertensive therapy in patients with type 2 diabetes and a blood pressure of ≥ 130/80 mm Hg or higher. First-line treatment options include ACE inhibitors, ARBs, calcium channel blockers, and thiazide diuretics. A 2017 meta-analysis demonstrated that these agents significantly reduced the risk for stroke by 27%, risk for coronary artery disease by 29%, heart failure by 25%, and all-cause mortality by 18% in patients with diabetes. In patients with albuminuria, an ACE inhibitor or an ARB is considered a first-line therapy, as it indicates slow progression of nephropathy and retinopathy.

Beta blockers may be considered to lower blood pressure; however, reduced mortality has only been observed in patients with established cardiovascular disease or heart failure.

Insulin and aspirin do not play a role in the management of hypertension in patients with type 2 diabetes.

Learn more about type 2 diabetes.


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