Treatment of hypertension in metabolic syndrome
Authors:
J. Widimský jr.
Authors‘ workplace:
Centrum pro hypertenzi III. interní kliniky 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in:
Vnitř Lék 2009; 55(7-8): 631-635
Category:
134th Internal Medicine Day - 23rd Vanysek's Day Brno 2009 - Vanysek's Lecture
Overview
Hypertension in metabolic syndrome is common. Basic principles of therapeutic approach like decrease of body weight are discussed. Goal blood pressure levels are ≤ 130/80 mm Hg. ACE‑inhibitors/AT1‑blockers are considered drugs of choice. In most cases it is necessary to combine at least two drugs. Preferred combination is ACE‑inhibitor/AT1‑blocker + calcium channel blocker.
Key words:
metabolic syndrome – hypertension – treatment
Sources
1. Kannel WB. Influence of multiple risk factors on the hazard of hypertension. J Cardiovasc Pharmacol 1990; 16: 353–357.
2. Reaven GM. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–1607.
3. Reaven GM. Syndrome X 6 years later. J Intern Med 1996; 236: 13–22.
4. National cholesterol Education Program III (NCEP III) – Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III). Circulation 2002; 106: 3143–3421.
5. Kahn R. Metabolic syndrome: is it a syndrome? Does it matter? Circulation 2007; 115: 1806–1810.
6. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. Br Med J 1998; 317: 703–713.
7. Hansson L, Zanchetti A, Carruthers SG et al. Effect of intensive blood pressure lowering and low dose of aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Lancet 1998; 351: 1755–1762.
8. ADVANCE Collaborative Group Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007; 370: 804–805.
9. Jamerson K, Weber MA, Bakris GL et al. ACCOMPLISH Trial Investigators. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high risk patiens. N Engl J Med 2008; 359: 2417–2428.
10. Redon J. The metabolic syndrome in hypertension. European Society of Hypertension Scientific Newsletter: Update on Hypertension Management 2009; 10: 38.
11. 2007 Guidelines for the Management of Arterial Hypertension. The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension and of the European Society of Cardiology. Guidelines Committee. J Hypertens 2007; 25: 1105–1187.
12. Widimský J jr., Cífková R, Špinar J et al. Doporučení diagnostických a léčebných postupů u arteriální hypertenze – verze 2007. Doporučení České společnosti pro hypertenzi. Cor Vasa 2008; 50: K5–K22.
13. Lindholm LH, Ibsen H, Dahlhof B et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 1004–1010.
14. Remuzzi G, Macia M, Ruggenenti P. Prevention and treatment of diabetic renal disease in type 2 diabetes: the BENEDICT study. J Am Soc Nephrol 2006; 17 (4 Suppl 2): S90–S97.
15. Yusuf S, Sleight P, Pogue J et al for The Heart Outcomes Prevention Evaluation study investigators. Effects of an angiotensin converting‑enzyme inhibitor, ramipril, on cardiovascular events in high risk patients. N Engl J Med 2000; 342: 145–153.
16. Lithell H, Hansson L, Skoog I et al. The study on cognition and prognosis in the elderly (SCOPE): principal results of a randomised double-blind intervention trial. J Hypertens 2003; 21: 875–886.
17. Staessen JA, Thijs L, Fagard R et al. Effects of immediate versus delayed antihypertensive therapy outcome in the Systolic Hypertension in Europe Trial. J of Hypertension 2004; 22: 847–857.
18. Bakris G, Molitch M, Hewkin A et al. Differences in glucose tolerance between fixed‑dose antihypertensive drug combinations in people with metabolic syndrome. Diabetes Care 2006; 29: 2592–2597.
19. Whelton PK, Barzilay J, Cushman WC et al. Clinical outcomes in antihypertensive treatment of type 2 diabetes, impaired fasting glucose concentration and normoglycemia: ALLHAT study. Arch Intern Med 2005; 165: 1401–1409.
20. Verdecchia P, Reboldi G, Angeli F et al. Adverse prognostic significance of new diabetes in treated hypertensive subjects. Hypertension 2004; 43: 963–969.
21. Almgren T, Wilhelmsen L, Samuelsson O et al. Diabetes in treated hypertension is common and carries a high cardiovascular risk: results from a 28-year follow‑up. J Hypertens 2007; 25: 1311–1317.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2009 Issue 7-8
Most read in this issue
- Metabolic syndrome and the liver (NAFLD/NASH)
- Anxious-depressive disorders and metabolic syndrome
- Chronic mild inflammation links obesity, metabolic syndrome, atherosclorosis and diabetes
- Laboratory markers of metabolic syndrome in clinical practice