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Recommendations for special populations: diabetes mellitus and the metabolic syndrome

Cardiovascular diseases (CVD) are the major causes of mortality in persons with diabetes, and many factors, including hypertension, contribute to this high prevalence of CVD. The incidence of hypertension in patients with diabetes is approximately twofold higher than in age-matched subjects without...

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Published in:	American journal of hypertension 2003-11, Vol.16 (11), p.41-45
Main Author:	Sowers, James R
Format:	Article
Language:	English
Subjects:	antihypertensive agents Antihypertensive Agents - therapeutic use Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Blood pressure Cardiology. Vascular system Diabetes Complications Diabetes Mellitus, Type 2 - complications diuretics Drug Therapy, Combination Humans hypertension Hypertension - complications Hypertension - drug therapy Hypolipidemic Agents - therapeutic use Medical sciences Metabolic Syndrome - complications Obesity - complications Platelet Aggregation Inhibitors - therapeutic use renin-angiotensin system Renin-Angiotensin System - drug effects Renin-Angiotensin System - physiology Risk Factors
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description	Cardiovascular diseases (CVD) are the major causes of mortality in persons with diabetes, and many factors, including hypertension, contribute to this high prevalence of CVD. The incidence of hypertension in patients with diabetes is approximately twofold higher than in age-matched subjects without the disease, and conversely, individuals with hypertension are at increased risk of developing diabetes compared with normotensive persons. Furthermore, because up to 75% of cases of CVD in patients with diabetes can be attributed to hypertension, aggressive management of elevated blood pressure (BP) (ie, to
doi_str_mv	10.1016/j.amjhyper.2003.07.009
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The incidence of hypertension in patients with diabetes is approximately twofold higher than in age-matched subjects without the disease, and conversely, individuals with hypertension are at increased risk of developing diabetes compared with normotensive persons. Furthermore, because up to 75% of cases of CVD in patients with diabetes can be attributed to hypertension, aggressive management of elevated blood pressure (BP) (ie, to <130/85 mm Hg) in these patients is essential for reduction in cardiovascular morbidity and mortality. The renin-angiotensin system is an important regulator of both BP and obesity, and its pharmacologic modulation may thus translate into significant cardiovascular benefits. Apart from hypertension and obesity, the important risk factors for CVD in patients with diabetes include atherosclerosis, dyslipidemia, microalbuminuria, endothelial dysfunction, platelet hyperaggregability, and coagulation abnormalities. Therefore, effective prevention of major cardiovascular events in patients with diabetes requires combination therapy with agents that target key factors contributing to cardiovascular morbidity and mortality. The antiplatelet and anti-inflammatory effects of aspirin, the lipid-lowering activity of statins, as well as the antihypertensive effects of various agents (eg, diuretics, β-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers) have all been demonstrated to provide substantial reductions in cardiovascular events.</description><identifier>ISSN: 0895-7061</identifier><identifier>EISSN: 1879-1905</identifier><identifier>EISSN: 1941-7225</identifier><identifier>DOI: 10.1016/j.amjhyper.2003.07.009</identifier><identifier>PMID: 14625160</identifier><identifier>CODEN: AJHYE6</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>antihypertensive agents ; Antihypertensive Agents - therapeutic use ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood pressure ; Cardiology. Vascular system ; Diabetes Complications ; Diabetes Mellitus, Type 2 - complications ; diuretics ; Drug Therapy, Combination ; Humans ; hypertension ; Hypertension - complications ; Hypertension - drug therapy ; Hypolipidemic Agents - therapeutic use ; Medical sciences ; Metabolic Syndrome - complications ; Obesity - complications ; Platelet Aggregation Inhibitors - therapeutic use ; renin-angiotensin system ; Renin-Angiotensin System - drug effects ; Renin-Angiotensin System - physiology ; Risk Factors</subject><ispartof>American journal of hypertension, 2003-11, Vol.16 (11), p.41-45</ispartof><rights>2003 American Journal of Hypertension, Ltd.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Nov 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4899-4bcef47fc8530c2ec90b5179bb30759d0838f051a63f0b16847c1a7919dc91c33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,777,781,786,787,23911,23912,25121,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15366865$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14625160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sowers, James R</creatorcontrib><title>Recommendations for special populations: diabetes mellitus and the metabolic syndrome</title><title>American journal of hypertension</title><addtitle>AJH</addtitle><description>Cardiovascular diseases (CVD) are the major causes of mortality in persons with diabetes, and many factors, including hypertension, contribute to this high prevalence of CVD. The incidence of hypertension in patients with diabetes is approximately twofold higher than in age-matched subjects without the disease, and conversely, individuals with hypertension are at increased risk of developing diabetes compared with normotensive persons. Furthermore, because up to 75% of cases of CVD in patients with diabetes can be attributed to hypertension, aggressive management of elevated blood pressure (BP) (ie, to <130/85 mm Hg) in these patients is essential for reduction in cardiovascular morbidity and mortality. The renin-angiotensin system is an important regulator of both BP and obesity, and its pharmacologic modulation may thus translate into significant cardiovascular benefits. Apart from hypertension and obesity, the important risk factors for CVD in patients with diabetes include atherosclerosis, dyslipidemia, microalbuminuria, endothelial dysfunction, platelet hyperaggregability, and coagulation abnormalities. Therefore, effective prevention of major cardiovascular events in patients with diabetes requires combination therapy with agents that target key factors contributing to cardiovascular morbidity and mortality. The antiplatelet and anti-inflammatory effects of aspirin, the lipid-lowering activity of statins, as well as the antihypertensive effects of various agents (eg, diuretics, β-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers) have all been demonstrated to provide substantial reductions in cardiovascular events.</description><subject>antihypertensive agents</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood pressure</subject><subject>Cardiology. Vascular system</subject><subject>Diabetes Complications</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>diuretics</subject><subject>Drug Therapy, Combination</subject><subject>Humans</subject><subject>hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - drug therapy</subject><subject>Hypolipidemic Agents - therapeutic use</subject><subject>Medical sciences</subject><subject>Metabolic Syndrome - complications</subject><subject>Obesity - complications</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>renin-angiotensin system</subject><subject>Renin-Angiotensin System - drug effects</subject><subject>Renin-Angiotensin System - physiology</subject><subject>Risk Factors</subject><issn>0895-7061</issn><issn>1879-1905</issn><issn>1941-7225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNqF0F2L1DAUBuAiiju7-heWguhd60nTfHmlDO6OsiiIi-JNSNNTNmPb1KQV59-boaML3ngVOHnO4eXNsksCJQHCX-5LM-zvDhOGsgKgJYgSQD3INkQKVRAF7GG2AalYIYCTs-w8xj0A1JyTx9kZqXnFCIdNdvsJrR8GHFszOz_GvPMhjxNaZ_p88tPSr_NXeetMgzPGfMC-d_MSczO2-XyHaTCbxvfO5vEwtsEP-CR71Jk-4tPTe5HdXr39vN0VNx-v323f3BS2lkoVdWOxq0VnJaNgK7QKGkaEahoKgqkWJJUdMGI47aAhXNbCEiMUUa1VxFJ6kb1Y707B_1gwznpw0aZ8ZkS_RC0IVZKRKsFn_8C9X8KYsmkCFWdKSX5UfFU2-BgDdnoKbjDhkJA-1q73-k_t-li7BqFT7Wnx8nR-aQZs79dOPSfw_ARMtKbvghmti_eOUc4lZ8kVq3Nxxl9__034rrmggund1296-55-uf5AKr1L_vXqMbX806VY0TocLbYuoJ11693_sv8G7wuzFg</recordid><startdate>200311</startdate><enddate>200311</enddate><creator>Sowers, James R</creator><general>Elsevier Inc</general><general>Oxford University Press</general><general>Elsevier Science</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200311</creationdate><title>Recommendations for special populations: diabetes mellitus and the metabolic syndrome</title><author>Sowers, James R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4899-4bcef47fc8530c2ec90b5179bb30759d0838f051a63f0b16847c1a7919dc91c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>antihypertensive agents</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood pressure</topic><topic>Cardiology. Vascular system</topic><topic>Diabetes Complications</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>diuretics</topic><topic>Drug Therapy, Combination</topic><topic>Humans</topic><topic>hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - drug therapy</topic><topic>Hypolipidemic Agents - therapeutic use</topic><topic>Medical sciences</topic><topic>Metabolic Syndrome - complications</topic><topic>Obesity - complications</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>renin-angiotensin system</topic><topic>Renin-Angiotensin System - drug effects</topic><topic>Renin-Angiotensin System - physiology</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sowers, James R</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sowers, James R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recommendations for special populations: diabetes mellitus and the metabolic syndrome</atitle><jtitle>American journal of hypertension</jtitle><addtitle>AJH</addtitle><date>2003-11</date><risdate>2003</risdate><volume>16</volume><issue>11</issue><spage>41</spage><epage>45</epage><pages>41-45</pages><issn>0895-7061</issn><eissn>1879-1905</eissn><eissn>1941-7225</eissn><coden>AJHYE6</coden><abstract>Cardiovascular diseases (CVD) are the major causes of mortality in persons with diabetes, and many factors, including hypertension, contribute to this high prevalence of CVD. The incidence of hypertension in patients with diabetes is approximately twofold higher than in age-matched subjects without the disease, and conversely, individuals with hypertension are at increased risk of developing diabetes compared with normotensive persons. Furthermore, because up to 75% of cases of CVD in patients with diabetes can be attributed to hypertension, aggressive management of elevated blood pressure (BP) (ie, to <130/85 mm Hg) in these patients is essential for reduction in cardiovascular morbidity and mortality. The renin-angiotensin system is an important regulator of both BP and obesity, and its pharmacologic modulation may thus translate into significant cardiovascular benefits. Apart from hypertension and obesity, the important risk factors for CVD in patients with diabetes include atherosclerosis, dyslipidemia, microalbuminuria, endothelial dysfunction, platelet hyperaggregability, and coagulation abnormalities. Therefore, effective prevention of major cardiovascular events in patients with diabetes requires combination therapy with agents that target key factors contributing to cardiovascular morbidity and mortality. The antiplatelet and anti-inflammatory effects of aspirin, the lipid-lowering activity of statins, as well as the antihypertensive effects of various agents (eg, diuretics, β-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers) have all been demonstrated to provide substantial reductions in cardiovascular events.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>14625160</pmid><doi>10.1016/j.amjhyper.2003.07.009</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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subjects	antihypertensive agents Antihypertensive Agents - therapeutic use Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Blood pressure Cardiology. Vascular system Diabetes Complications Diabetes Mellitus, Type 2 - complications diuretics Drug Therapy, Combination Humans hypertension Hypertension - complications Hypertension - drug therapy Hypolipidemic Agents - therapeutic use Medical sciences Metabolic Syndrome - complications Obesity - complications Platelet Aggregation Inhibitors - therapeutic use renin-angiotensin system Renin-Angiotensin System - drug effects Renin-Angiotensin System - physiology Risk Factors
title	Recommendations for special populations: diabetes mellitus and the metabolic syndrome
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