Hypertension in Diabetes: Considering Therapies which Optimise Kidney Protection
Hypertension and Diabetes remain the top two causes of End-Stage Renal Disease (ESRD) (1). Hence, it seems clinically appropriate to establish that when Hypertension and Diabetes come together, they possess the greatest dual threat to the kidneys. Hypertension in diabetes management, therefore, requires a more prudent approach for optimal renal outcomes, which independently could improve cardiovascular outcomes. Renin-Angiotensin System (RAS) Blockers in combination with clinically proven nephroprotective Calcium Channel Blockers (CCBs) seem to be valuable fixed-dose combination options for the management of blood pressure control and target organ protection in hypertensive patients with Diabetes.
Hypertension and diabetes are becoming progressively common. Hypertension affects up to 60% of patients with diabetes, depending on obesity, ethnicity, and age (2) . Hypertension is found to be disproportionately higher in patients with Diabetes. Individuals with elevated BP are two and a half times more likely to develop diabetes within 5 years (3), and in India, it is estimated that about 50% of diabetic patients have hypertension (4) . Most patients with both disorders stand a higher risk for premature microvascular and macrovascular complications. The presence of hypertension leads to a 7.2-fold increase in mortality in diabetic patients (5)
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Dr Sujoy Ghosh, DM ( Endocrinology), F.R.C.P. (London, Glasgow, Edinburgh), F.A.C.E., is a noted endocrinologist in West Bengal and is currently associated as a Professor of Endocrinology at IPGME&R Kolkata. He is an avid writer and is currently serving as Editor in chief: Oxford handbook series (South East Asia Edition) as well as Executive Editor: Thyroid Research & Practice and the Indian Journal of Endocrinology & Metabolism.