The Management of Hypertension in People With Diabetes

Abstract

According to the 2017 American College of Cardiology (ACC) and American Heart Association (AHA) guidelines, unmanaged hypertension is responsible for more cardiovascular-related deaths in the United States than any modifiable risk factor except smoking. Its prevalence depends on the blood pressure used to classify patients. Estimates using ACC/AHA criteria of 130/80 mmHg now suggest 46% or nearly half the US population has high blood pressure. A study from the American Heart Journal found people with diabetes are twice as likely to have hypertension compared to others at the same age without diabetes and have an overall prevalence of 80%. The high prevalence of hypertension in people with diabetes elevates their risk for the development of microand macrovascular complications. Both contribute to morbidity and mortality in people with diabetes, but data from the UKPDS trial found the leading cause of death is due to macrovascular disease. The purpose of this article is to review the application of the 2017 ACC/AHA blood pressure guidelines to people with diabetes.