Issue 112 Item 8 Diabetics Must Control Hypertension

ABC’s of controlling hypertension in people with diabetes. Normalizing blood pressure is critical, especially in the diabetic patient. Unfortunately, many people don’t realize they have hypertension until a medical catastrophe occurs, such as a major heart attack.

When treating a diabetic, physicians may prescribe one of two types of drugs: either an ACE inhibitor or an AR blocker.

An ACE inhibitor, such as Accupril, Altace, Monopril, Zestril, Prinivil, Vasotec, Lotensin or Capoten, may be prescribed for you as the first therapeutic weapon to combat vascular disease.

Of these drugs, Accupril and Altace are preferred by some doctors because of their beneficial effect on the kidneys of a diabetic.

An AR blocker may be used instead. These include Avapro, Diovan, Atacand, Cozaar and Micardis.

These are used rather than ACE inhibitors because they stay focused on specific blood vessels, so they cause fewer side effects elsewhere in the body.

In resistant patients, other medications such as calcium-channel blockers or water pills may work. In fact, water pills (diuretics) are quite popular and sometimes used as first-line agents. It just depends. Diuretics reduce the pressure in your vascular "pipes" by causing you to urinate excessive fluid. Don’t take them at night or you’ll spend more time in the bathroom than in the bedroom.

Compliance is important. If you have a good health-care team and a regimen that is working, don’t be distracted. Stick to it and monitor your blood pressure frequently.