Resistant Hypertension in Adults With Type 1 or 2 Diabetes: A Structured Diagnostic Approach

Publication date: April 2018Source: Canadian Journal of Diabetes, Volume 42, Issue 2Author(s): Philip A. McFarlaneAbstractPeople with diabetes often have difficulty reaching their blood pressure targets and are labelled as having resistant hypertension. Clinicians often move quickly to screen such people for secondary causes of hypertension; however, such causes are rare, and resistant hypertension usually has other explanations that are significantly more common. By using a structured approach to resistant hypertension, clinicians can assist patients to reach their target blood pressure levels. Step 1 is to determine out-of-office blood pressure measurements using home or ambulatory blood pressure monitors. Step 2 is to determine the level of adherence to prescribed medications. Step 3 is to identify interfering substances. Step 4 is to check that the prescribed medications are synergistic and optimally dosed. Finally, if all other steps fail to get patients to their blood pressure targets, we consider possible secondary causes of hypertension. This approach is particularly useful in helping people with diabetes to reach their blood pressure targets.RésuméLes personnes diabétiques ont souvent de la difficulté à atteindre les valeurs cibles de la pression artérielle et sont étiquetées comme des personnes atteintes d'hypertension résistante. Les cliniciens s'empressent souvent de déterminer les causes secondaires de l'hypertension chez ces personnes. Toutefois, ces c...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research