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Hypertension (in Type I diabetics with nephropathy)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • hypertension in type I diabetics is often an indication of diabetic nephropathy

  • in type I diabetics blood pressure reduction and ACE inhibitors slow the rate of decline of renal function in overt diabetic nephropathy; also they delay the progression from microalbuminuric phase to overt nephropathy

  • ACE inhibition should be titrated to the maximum dose tolerated and recommended

  • the target blood pressure is described in the menu item

  • combination therapy is invariably required to achieve blood pressure targets

  • even in the presence of a normal blood pressure Type I diabetics with persistent microalbuminuria or proteinuria may also benefit from ACE-inhibition titrated to the recommended maximum dose

  • in the presence of frank proteinuria, in addition to BP control with ACE inhibitors; some suggest protein intake should be reduced to <0.6 g/kg body weight/day

  • measures should also be taken to alter other risk factors such as smoking, obesity and dyslipidaemia

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