The American College of Physicians (ACP) is emphatic in its new guidelines: Focusing on the blood pressure of patients with type 2 diabetes should be a priority that is at least equal to the focus on blood sugar. High blood pressure is a common problem in people with type 2 diabetes, contributing to their elevated risk of heart disease, stroke, and early death.
According to Vincenza Snow, MD, senior medical associate at ACP and an author of the guidelines, the target blood pressure for such patients should be 135/80 mm Hg. The guidelines suggest that either thiazide diuretics or angiotensin-converting enzyme inhibitors can be used as first-line therapy. But the guidelines emphasize that many diabetics may need more than 1 drug to adequately control their blood pressure.
The guidelines are based on a review of clinical trial data conducted by Sandeep Vijan, MD, and Rodney A. Hayward, MD, of the University of Michigan in Ann Arbor. Some trials compared blood pressure drugs versus placebo, and others compared the effects of different drug classes. Some studies looked at the effects of achieving various blood pressure targets.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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