Hypertension in diabetes

Question 1

What is the blood pressure target for type 1 diabetics?

Answer 1

Below 130/80 mm/Hg

Question 2

What is the blood pressure target for type 2 diabetics?

Answer 2

Below 140/90 mm/Hg (same as non-diabetics)
Below 150/90 mm/Hg if over 80 years old

Question 3

What is the first line treatment of hypertension in diabetes with example and doses?

Answer 3

• Offer ARB or ACEI
  In diabetes would use and ACEI as it has renoprotective qualities
  e.g. Ramipril
  Initially 1.25-2.5 mg OD, can be increased up to 10mg OD

Question 4

What is the second line treatment of hypertension in diabetes with example and doses?

Answer 4

• Offer calcium channel blocker or thiazide-like diuretic
  CCB- e.g. Amlodipine- 5mg OD, can be increased to 10 mg OD
  Thiazide-like diuretic- e.g. Indapamide- 2.5mg OM

Question 5

What is the third line treatment of hypertension in diabetes with example and doses?

Answer 5

Consider both a CCB and a thiazide-like diuretic with the ACEI
e.g.
CCB- e.g. Amlodipine- 5mg OD, can be increased to 10 mg OD
Thiazide-like diuretic- e.g. Indapamide- 2.5mg OM