Antihypertensive therapy for the prevention of nephropathy in diabetic hypertensive patients

作者：Isaacs A N^*; Vincent A

来源：Journal of Clinical Pharmacy and Therapeutics, 2016, 41(2): 111-115.

DOI：10.1111/jcpt.12361

• ACE inhibitors
• angiotensin II receptor antagonists
• calcium channel blockers
• diabetes
• hypertension
• nephropathy

What is known and objectiveAlthough antihypertensive recommendations exist for diabetic nephropathy, there is less guidance for diabetics with normoalbuminuria. Therefore, this review evaluates antihypertensives in preventing nephropathy in diabetic hypertensive patients.
CommentA literature search was performed using PubMed and Medline for primary literature from 1978 through August 2015. Search terms included diabetes mellitus, normoalbuminuria, hypertension, ACE inhibitor, ARB and calcium channel blocker. There was no literature evaluating antihypertensive therapies in preventing nephropathy in type 1 hypertensive diabetics. However, in patients with type 2 diabetes and hypertension, multiple studies demonstrate the benefit of an ACEI or ARB in preventing or delaying the onset of nephropathy, while no study demonstrated the benefit of a CCB over an ACEI or ARB.
What is new and conclusionDue to the lack of literature, hypertension management in type 1 diabetics with normoalbuminuria should be guided by the treatment of comorbidities. To prevent diabetic nephropathy, an ACEI or ARB should be first-line monotherapy over a CCB for the management of hypertension in patients with type 2 diabetes mellitus, hypertension and normoalbuminuria.

• 出版日期2016-4