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Vol. 31. Issue 1.
Pages 31-47 (January - February 2019)
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Vol. 31. Issue 1.
Pages 31-47 (January - February 2019)
Review article
Blood pressure control and impact on cardiovascular events in patients with type 2 diabetes mellitus: A critical analysis of the literature
Metas de control de la presión arterial e impacto sobre desenlaces cardiovasculares en pacientes con diabetes mellitus tipo 2: un análisis crítico de la literatura
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Hernando Vargas-Uricoechea
Corresponding author
, Manuel Felipe Cáceres-Acosta
Grupo de estudio de enfermedades metabólicas, Facultad Ciencias de la Salud, Departamento de Medicina Interna, Universidad del Cauca, Popayán, Cauca, Colombia
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Table 1. Blood pressure targets in type 2 diabetes mellitus, from various management guidelines.
Table 2. Observational studies and clinical trials that have evaluated the effect of blood pressure therapy in type 2 diabetes mellitus.
Table 3. Meta-analyses that have evaluated the effect of blood pressure therapy in type 2 diabetes mellitus.
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Abstract

High blood pressure in individuals with type2 diabetes mellitus increases the risk of cardiovascular events. The international management guidelines recommend starting pharmacological treatment with blood pressure values >140/90mmHg. However, there is no optimal cut-off point from which cardiovascular events can be reduced without causing adverse events. A blood pressure range of >130/80 to <140/90mmHg seems to be adequate. These values can be achieved through non-pharmacological (diet, exercise) and pharmacological interventions (using drugs that have been shown to reduce cardiovascular events). The choice of one or several drugs must be individualised, according to factors including, ethnicity, age, and associated comorbidities, among others.

Keywords:
Diabetes
Arterial hypertension
Cardiovascular
Anti-hypertensive drugs
Resumen

La hipertensión arterial en individuos con diabetes mellitus tipo2 incrementa el riesgo de eventos cardiovasculares. Las guías internacionales de manejo recomiendan iniciar tratamiento farmacológico con valores de presión arterial >140/90mmHg. Sin embargo, no existe un punto de corte óptimo a partir del cual se logre reducir los eventos cardiovasculares sin originar eventos adversos; un rango de presión arterial >130/80 y <140/90mmHg parece ser el adecuado. Estos valores pueden alcanzarse mediante intervenciones no farmacológicas (dieta, ejercicio) y farmacológicas (por fármacos que hayan demostrado reducir eventos cardiovasculares). La elección de uno o varios fármacos debe ser individualizada, de acuerdo con factores como etnia, edad, comorbilidades asociadas, entre otros.

Palabras clave:
Diabetes
Hipertensión arterial
Cardiovascular
Antihipertensivos

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