Sandeep Vijan1. 1. University of Michigan, Ann Arbor, MI, USA.
Abstract
INTRODUCTION: Among people with diabetes, about 40% of those aged 45 years, and more than 60% of those aged 75 years or over, will have a blood pressure over 140/90 mmHg. Major cardiac events occur in approximately 5% of people with diabetes and untreated hypertension each year, and the risk is higher in those with other risk factors, such as diabetic nephropathy. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antihypertensives in people with diabetes and hypertension? What are the effects of different blood pressure targets in people with diabetes and hypertension? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: alpha-blockers, angiotensin II receptor antagonists, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, blood pressure targets (lower or higher), calcium-channel blockers, and diuretics.
INTRODUCTION: Among people with diabetes, about 40% of those aged 45 years, and more than 60% of those aged 75 years or over, will have a blood pressure over 140/90 mmHg. Major cardiac events occur in approximately 5% of people with diabetes and untreated hypertension each year, and the risk is higher in those with other risk factors, such as diabetic nephropathy. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antihypertensives in people with diabetes and hypertension? What are the effects of different blood pressure targets in people with diabetes and hypertension? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: alpha-blockers, angiotensin II receptor antagonists, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, blood pressure targets (lower or higher), calcium-channel blockers, and diuretics.
Authors: Giuseppe Mancia; Morris Brown; Alain Castaigne; Peter de Leeuw; Christopher R Palmer; Talma Rosenthal; Gilbert Wagener; Luis M Ruilope Journal: Hypertension Date: 2003-02-17 Impact factor: 10.190
Authors: L Hansson; T Hedner; P Lund-Johansen; S E Kjeldsen; L H Lindholm; J O Syvertsen; J Lanke; U de Faire; B Dahlöf; B E Karlberg Journal: Lancet Date: 2000-07-29 Impact factor: 79.321
Authors: Ramachandran S Vasan; Alexa Beiser; Sudha Seshadri; Martin G Larson; William B Kannel; Ralph B D'Agostino; Daniel Levy Journal: JAMA Date: 2002-02-27 Impact factor: 56.272
Authors: L H Lindholm; L Hansson; T Ekbom; B Dahlöf; J Lanke; E Linjer; B Scherstén; P O Wester; T Hedner; U de Faire Journal: J Hypertens Date: 2000-11 Impact factor: 4.844
Authors: Lars H Lindholm; Hans Ibsen; Björn Dahlöf; Richard B Devereux; Gareth Beevers; Ulf de Faire; Frej Fyhrquist; Stevo Julius; Sverre E Kjeldsen; Krister Kristiansson; Ole Lederballe-Pedersen; Markku S Nieminen; Per Omvik; Suzanne Oparil; Hans Wedel; Peter Aurup; Jonathan Edelman; Steven Snapinn Journal: Lancet Date: 2002-03-23 Impact factor: 79.321