Chapter 17. Prevention of Hypertension

  1. R. Williams2,
  2. W. Herman3,
  3. A.-L. Kinmonth5 and
  4. N. J. Wareham4
  1. John Fuller

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch17

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Fuller, J. (2002) Prevention of Hypertension, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch17

Editor Information

  1. 2

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 3

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 4

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 5

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • cardiovascular disease;
  • retinopathy;
  • neuropathy;
  • nephropathy;
  • epidemiology;
  • guidelines;
  • blood pressure;
  • antihypertensive therapy

Summary

There is increasing epidemiological evidence that raised arterial pressure ranks with hyperglcyaemia as a major modifiable risk factor for chronic diabetic complications. The prevalence of hypertension is increased in type 2 diabetes and is often present at diagnosis or even in the pre-diabetic phase of glucose intolerance associated with insulin resistance. On the other hand the incidence of diabetes is increased 2.5 times in hypertensive compared with normotensive individuals. The chapter reviews the relationship of raised blood pressure to diabetic complications and assesses the evidence for the efficacy of antihypertensive therapy for their prevention. Specific complications addressed are cardiovascular disease, retinopathy, neuropathy and nephropathy. Completed and ongoing clinical trials are clarifying the threshold levels of blood pressure above which antihypertensive treatment is of benefit. However, the control of hypertension in diabetic populations is far from satisfactory in many parts of the world, posing a challenge for those responsible for diabetes care programmes.