This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (36)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A. Richard Christlieb, MD

A. Richard Christlieb, MD

Arch Intern Med. 1990;150(6):1167-1174.

Abstract
• Hypertension occurs with twice the frequency in the diabetic population as compared with the general nondiabetic population. Treatment of hypertension in diabetics can be complicated by diabetic complications and the potential for adverse effects from selected antihypertensive drugs. A rational approach to antihypertensive therapy in diabetics with or without concurrent diabetic complications incorporates a "stepped" approach to therapy that includes alternative step 1 agents (eg, angiotensinconverting enzyme inhibitors and calcium channel blockers) rather than traditional agents (eg, diuretics and β-blockers). Evolving evidence with angiotensin-converting enzyme inhibitors reveals that they do not exacerbate complications of diabetes mellitus and also may arrest or slow the progression of diabetic nephropathy. Treatment algorithms for a stepped approach to the management of the hypertensive diabetic patient are proposed.

(Arch Intern Med. 1990;150:1167-1174)

Author Affiliations
From the Epidemiology and Genetics Section and the Joslin Clinic Division of the Joslin Diabetes Center, Department of Medicine, New England Deaconess Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Footnotes
Accepted for publication December 30,1989.

Reprint requests to the Joslin Clinic, One Joslin Place, Boston, MA 02215 (Dr Christlieb).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Treatment of Mild Hypertension: Decision Before Drugs
Zell and Lardinois
Arch Fam Med 1993;2:778-786.
ABSTRACT  

Proteinuria, Renal Impairment, Metabolic Control, and Blood Pressure in Type 2 Diabetes Mellitus: A 14-Year Follow-up Report on 195 Patients
Ravid et al.
Arch Intern Med 1992;152:1225-1229.
ABSTRACT  

Two Dilemmas of Diabetes
Kaplan
Arch Intern Med 1991;151:1270-1272.
ABSTRACT