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Kim: Management of Hypertension in Diabetic Patients
Focused Issue

J Korean Diabetes 2016;17(2):88-95.

Published online: 10 January 2016

DOI: https://doi.org/10.4093/jkd.2016.17.2.88

Management of Hypertension in Diabetic Patients

Sang Yong Kim

Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Korea

Corresponding author: Sang Yong Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, Chosun University, Philmoodaero 309, Dong-gu, Gwangju, Korea, E-mail: diabetes@chosun.ac.kr

      Revised 1 May 2016       Accepted 6 May 2016

Copyright © 2016 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diabetes mellitus is a major chronic disease worldwide, and its prevalence is expected to increase in the near future. Because cardiovascular disease continues to be the leading cause of morbidity and mortality in diabetic patients, it is important to detect and address other risk factors of cardiovascular disease such as hypertension and dyslipidemia. Moreover, presence of diabetes increases the risk of developing hypertension. Despite significant advances in the understanding of the pathophysiology and treatment of hypertension, there are still many debates regarding the management of hypertension, especially in patients with diabetes. The most important unresolved questions are at what blood pressure to initiate drug therapy and the target blood pressure. Recently, the Korean Diabetes Association published “Treatment Guideline for Diabetes 2015.” This review will compare major guidelines from other countries and discuss how to determine the target goal for blood pressure control in Korean diabetic patients.

Keywords: Diabetes mellitus, Hypertension, Treatment guideline

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Table 1.
Comparison of hypertension guidelines 2011∼2015
Guideline Blood pressure target in general populations (mm Hg) Blood pressure target in diabetic patients (mm Hg)
NICE, 2011 [8] < 140/90 (< 150/90 if older than 80 years) Not addressed
ESH/ESC, 2013 [4] < 140/90 (systolic Blood Pressure < 140/85
< 150 if fragile elderly)
AHA/ACC/CDC, 2014 [5] < 140/90 (lower target might be appropriate in some patients) < 140/90 (lower target might be appropriate in some patients)
ASH/ISH, 2014 [6] < 140/90 (< 150/90 if older than 80 years) < 140/90 (lower target can be considered in younger patients)
JNC-8, 2014 [9] <140/90 younger than 60 years < 140/90
< 150/90 older than 60 years
ADA, 2015 [17] Not addressed < 140/90 (lower target might be appropriate in some patients)
JSH, 2014 [18] < 140/90 (lower target might be appropriate in some patients) < 130/80
TSC/THS, 2015 [19] < 140/90 (< 150/90 if older than 80 years, lower target might be appropriate in some patients) < 130/80
KDA, 2015 [1] Not addressed < 140/85 (lower target might be appropriate in some patients)

NICE, National Institute for Health and Care Excellence; ESH/ESC, European Society of Hypertension/European Society of Cardiology; AHA/ACC/CDC, American Heart Association/American College of Cardiology/Center for Disease Control; ASH/ISH, American Society of Hypertension/International Society of Hypertension; JNC, Joint National Committee; ADA, American Diabetes Association; JSH, Japanese Society of Hypertension; TSC/THS, Taiwan Society of Cardiology/Taiwan Hypertension Society; KDA, Korean Diabetes Association.

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