Hypertension with Comorbidities - Challenges and Treatment Options


Dr Tushar Dighe    13 January 2018

Latest updated assessment and treatment of hypertension among people with diabetes, including advances in care, a positioning statement by the ADA recommend in patients with a high risk of CVD, a lower BP target of <130/80 mmHg. The updated recommendations are based on review of 137 clinical trials and meta-analyses including; ACCORD BP, ADVANCE BP, HOT and SPRINT Trials.

The report “strongly recommends” that home BP monitoring be carried out by all hypertensive patients with diabetes with periodic reporting. New recommendations provide lifestyle management plans for lowering BP that include suggestions for weight loss, a Dietary Approaches to Stop Hypertension (DASH)–style food plan and increased physical activity.

The new ADA 2017 Treatment of Hypertension in patients with Diabetes guideline recommends <130/80 mmHg BP goal for diabetes with high risk of CVD. This recommendation further strengthens the use of Azilsartan in T2DM with high risk of CVD. Azilsartan medoxomil is a new ARB for the treatment of hypertension, with its potent BP-lowering ability associated with considerably better rates of hypertension control compared with other antihypertensive drugs including other ARBs at standard doses. Recent studies comparing Azilsartan with ARBs and an ACEI have demonstrated that azilsartan was more effective at lowering ambulatory systolic and diastolic BP. Azilsartan, thus looks promising in controlling BP in hypertensive patients having comorbid conditions.

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