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Diabetes und Hypertonie

Teufel und Beelzebub

Diabetes and hypertension

Devil and Beelzebub

  • Leitthema
  • Published:
Der Diabetologe Aims and scope

Zusammenfassung

Hintergrund

Diabetes mellitus ist eine Erkrankung, welche über Gefäßschädigungen zu schwerwiegenden Folgeerkrankungen wie Myokardinfarkt oder Schlaganfall führt. Verstärkt wird dieser Prozess, wenn zusätzlich eine Hypertonie vorliegt.

Ziel der Arbeit

Die vorliegende Analyse gibt einen Überblick der neuesten Studienergebnisse zu Prognose, Blutdruckzielen, medikamentöser und interventioneller Therapie bei Patienten mit Diabetes mellitus und Hypertonie. Dabei wird über ausgewählte Studien des letzten Jahres mit praktischer Relevanz für Patienten mit Diabetes mellitus und Hypertonie berichtet.

Resümee

Gleichzeitig von einem Diabetes mellitus und einer Hypertonie Betroffene haben eine deutlich schlechtere Prognose und ein höheres kardiovaskuläres Risiko. Aber auch diese Patienten profitieren von einer interventionellen Blutdrucktherapie.

Abstract

Background

Diabetes mellitus is a disease which leads to vascular damage resulting in subsequent severe cardiovascular complications, such as myocardial infarction and stroke. This process is aggravated by coexisting hypertension.

Objective

This analysis gives a review of the latest study results on prognosis, blood pressure targets, drug therapy and interventional therapy in patients with diabetes and hypertension. Selected studies published in recent years with practical relevance for patients with diabetes and hypertension are presented.

Summary

Patients with simultaneous diabetes and hypertension have a poorer prognosis and a higher cardiovascular risk compared to patients with diabetes but without hypertension. Patients with diabetes and hypertension benefit from interventional blood pressure therapy

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Referenzen

  1. Vazquez-Benitez G, Desai JR, Xu S, Goodrich GK, Schroeder EB, Nichols GA, Segal J, Butler MG, Karter AJ, Steiner JF, Newton KM, Morales LS, Pathak RD, Thomas A, Reynolds K, Kirchner HL, Waitzfelder B, Elston Lafata J, Adibhatla R, Xu Z, O’Connor PJ (2015) Preventable major cardiovascular events associated with uncontrolled glucose, blood pressure, and lipids and active smoking in adults with diabetes with and without cardiovascular disease: A contemporary analysis. Diabetes Care 38:905–912

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Group AS, Cushman WC, Evans GW, Byington RP, Goff DC Jr., Grimm RH Jr., Cutler JA, Simons-Morton DG, Basile JN, Corson MA, Probstfield JL, Katz L, Peterson KA, Friedewald WT, Buse JB, Bigger JT, Gerstein HC, Ismail-Beigi F (2010) Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 362:1575–1585

    Article  Google Scholar 

  3. Margolis KL, O’Connor PJ, Morgan TM, Buse JB, Cohen RM, Cushman WC, Cutler JA, Evans GW, Gerstein HC, Grimm RH Jr., Lipkin EW, Narayan KM, Riddle MC Jr., Sood A, Goff DC Jr. (2014) Outcomes of combined cardiovascular risk factor management strategies in type 2 diabetes: The accord randomized trial. Diabetes Care 37:1721–1728

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Group SR, Wright JT Jr., Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, Reboussin DM, Rahman M, Oparil S, Lewis CE, Kimmel PL, Johnson KC, Goff DC Jr., Fine LJ, Cutler JA, Cushman WC, Cheung AK, Ambrosius WT (2015) A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 373:2103–2116

    Article  Google Scholar 

  5. Arauz-Pacheco C, Parrott MA, Raskin P, American Diabetes A (2003) Treatment of hypertension in adults with diabetes. diabetes Care 26(Suppl 1):S80–82

    PubMed  Google Scholar 

  6. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Task Force M (2013) esh/esc guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the european society of hypertension (esh) and of the european society of cardiology (esc). J Hypertens 31:1281–1357

    Article  CAS  PubMed  Google Scholar 

  7. O’Connor PJ, Vazquez-Benitez G, Schmittdiel JA, Parker ED, Trower NK, Desai JR, Margolis KL, Magid DJ (2013) Benefits of early hypertension control on cardiovascular outcomes in patients with diabetes. Diabetes Care 36:322–327

    Article  PubMed  PubMed Central  Google Scholar 

  8. Olde Engberink RH, Frenkel WJ, van den Bogaard B, Brewster LM, Vogt L, van den Born BJ (2015) Effects of thiazide-type and thiazide-like diuretics on cardiovascular events and mortality: Systematic review and meta-analysis. Hypertension 65:1033–1040

    Article  CAS  PubMed  Google Scholar 

  9. Roush GC, Ernst ME, Kostis JB, Tandon S, Sica DA (2015) Head-to-head comparisons of hydrochlorothiazide with indapamide and chlorthalidone: Antihypertensive and metabolic effects. Hypertension 65:1041–1046

    Article  CAS  PubMed  Google Scholar 

  10. Zoungas S, Chalmers J, Neal B, Billot L, Li Q, Hirakawa Y, Arima H, Monaghan H, Joshi R, Colagiuri S, Cooper ME, Glasziou P, Grobbee D, Hamet P, Harrap S, Heller S, Lisheng L, Mancia G, Marre M, Matthews DR, Mogensen CE, Perkovic V, Poulter N, Rodgers A, Williams B, MacMahon S, Patel A, Woodward M, Group A‑OC (2014) Follow-up of blood-pressure lowering and glucose control in type 2 diabetes. N Engl J Med 371:1392–1406

    Article  PubMed  Google Scholar 

  11. Bhatt DL, Kandzari DE, O’Neill WW, D’Agostino R, Flack JM, Katzen BT, Leon MB, Liu M, Mauri L, Negoita M, Cohen SA, Oparil S, Rocha-Singh K, Townsend RR, Bakris GL, Investigators SH (2014) A controlled trial of renal denervation for resistant hypertension. N Engl J Med 370:1393–1401

    Article  CAS  PubMed  Google Scholar 

  12. Kandzari DE, Bhatt DL, Brar S, Devireddy CM, Esler M, Fahy M, Flack JM, Katzen BT, Lea J, Lee DP, Leon MB, Ma A, Massaro J, Mauri L, Oparil S, O’Neill WW, Patel MR, Rocha-Singh K, Sobotka PA, Svetkey L, Townsend RR, Bakris GL (2015) Predictors of blood pressure response in the symplicity htn-3 trial. Eur Heart J 36:219–227

    Article  PubMed  Google Scholar 

  13. Azizi M, Sapoval M, Gosse P, Monge M, Bobrie G, Delsart P, Midulla M, Mounier-Vehier C, Courand PY, Lantelme P, Denolle T, Dourmap-Collas C, Trillaud H, Pereira H, Plouin PF, Chatellier G (2015) Renal Denervation for Hypertension i. Optimum and stepped care standardised antihypertensive treatment with or without renal denervation for resistant hypertension (denerhtn): A multicentre, open-label, randomised controlled trial. Lancet 385:1957–1965

    Article  PubMed  Google Scholar 

  14. Bohm M, Mahfoud F, Ukena C, Hoppe UC, Narkiewicz K, Negoita M, Ruilope L, Schlaich MP, Schmieder RE, Whitbourn R, Williams B, Zeymer U, Zirlik A, Mancia G, Investigators GSR (2015) First report of the global symplicity registry on the effect of renal artery denervation in patients with uncontrolled hypertension. Hypertension 65:766–774

    Article  PubMed  Google Scholar 

  15. Dzau VJ, Antman EM, Black HR, Hayes DL, Manson JE, Plutzky J, Popma JJ, Stevenson W (2006) The cardiovascular disease continuum validated: Clinical evidence of improved patient outcomes: Part i: Pathophysiology and clinical trial evidence (risk factors through stable coronary artery disease). Circulation 114:2850–2870

    Article  PubMed  Google Scholar 

  16. Perkovic V, Rodgers A (2015) Redefining blood-pressure targets – sprint starts the marathon. N Engl J Med 373:2175–2178

    Article  PubMed  Google Scholar 

  17. Sakakura K, Ladich E, Cheng Q, Otsuka F, Yahagi K, Fowler DR, Kolodgie FD, Virmani R, Joner M (2014) Anatomic assessment of sympathetic peri-arterial renal nerves in man. J Am Coll Cardiol 64:635–643

    Article  PubMed  Google Scholar 

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Correspondence to R. E. Schmieder.

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Interessenkonflikt

I. Kistner und R. E. Schmieder geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Kistner, I., Schmieder, R.E. Diabetes und Hypertonie . Diabetologe 12, 312–318 (2016). https://doi.org/10.1007/s11428-016-0115-4

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  • DOI: https://doi.org/10.1007/s11428-016-0115-4

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