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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Cite this: Romesh Khardori. Fast Five Quiz: Type 2 Diabetes and Cerebrovascular Disease - Medscape - Apr 27, 2022.
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