Leonardo A Sechi, MD, Clinica Medica, Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Via delle Scienze 208, 33100 Udine, Italy. sechi@uniud.it
Research Domain of This Article
Peripheral Vascular Disease
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Cristiana Catena, GianLuca Colussi, Francesca Nait, Gabriele Brosolo, Leonardo A Sechi, Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, 33100 Udine, Italy
Author contributions: Catena C and Sechi LA planned the article outline, retrived articles from the literature and wrote the manuscript; Colussi G, Nait F and Brosolo G retrieved articles from the literature and critically reviewed the manuscript.
Supported by The European Cooperation in the field of Scientific and Technical Research grant to Catena C, No. COST-BM1301; and a generous contribution of the PierSilverio Nassimbeni Foundation to Catena C and Sechi LA.
Conflict-of-interest: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Leonardo A Sechi, MD, Clinica Medica, Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Via delle Scienze 208, 33100 Udine, Italy. sechi@uniud.it
Telephone: +39-432-559804 Fax: +39-432-559890
Received: November 10, 2014 Peer-review started: November 10, 2014 First decision: November 27, 2014 Revised: December 9, 2014 Accepted: December 18, 2014 Article in press: December 19, 2014 Published online: February 23, 2015
Abstract
Association of diabetes with hypertension is frequent and it well known that high blood pressure potentiates the probability of diabetic patients to develop macrovascular and microvascular complications. Strong evidence obtained in a number of large scale prospective studies indicates that adequate blood pressure control in diabetic patients is highly beneficial for prevention of cardiovascular events. Nonetheless, only a limited proportion of hypertensive-diabetic individuals included in studies on anti-hypertensive treatment has met the predefined blood pressure goal. The optimal blood pressure goal to be pursued in diabetic patients with hypertension to guarantee effective protection from cardiovascular outcomes is still under intense debate and recommendations of current guidelines on hypertension treatment are still inconsistent. We comment here on the most important studies and conclude that current evidence does not conclusively support the need to reach a blood pressure target in hypertensive patients with diabetes different from nondiabetic hypertensive individuals.
Core tip: Hypertension potentiates the probability of diabetic patients to develop macrovascular and microvascular complications and prospective studies demonstrate that adequate blood pressure control in diabetic patients is highly beneficial for prevention of cardiovascular events. Blood pressure targets in diabetic patients with high blood pressure are under debate and are discussed in this editorial.
