cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1437Research ArticleОБЗОРЫREVIEWSНовые рубежи в лечении артериальной гипертонии у пациентов с сахарным диабетомNew advances in treating patients with arterial hypertension and diabetes mellitusШальноваС. А.ShalnovaS. A.

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oganov@gnicpm.ruВихиреваО. В.VikhirevaO. V.oganov@gnicpm.ruГосударственный научно-исследовательский центр профилактической медицины Росмедтехнологии, МоскваРоссияState Research Center for Preventive Medicine, Federal Agency on High Medical Technologies, MoscowRussian Federation2007201220076698102Copyright © Шальнова С.А., Вихирева О.В., 20072007Шальнова С.А., Вихирева О.В.Shalnova S.A., Vikhireva O.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1437

Статья содержит обзор литературы по весьма важной проблеме – лечение артериальной гипертонии (АГ) у больных сахарным диабетом 2 типа (СД-2). Известно, что АГ встречается в три раза чаще у пациентов с СД-2, а сочетание этих патологий опасно и повышает риск поражения органов-мишеней (ПОМ). В работе дан анализ различных исследований, результаты которых объясняют причины дополнительного увеличения риска ПОМ, и делается вывод, что контроль артериального давления является важным аспектом в лечении больных СД-2. Обсуждаются вопросы о важности метаболических эффектов различных антигипертензивных средств в плане долгосрочного сердечно-сосудистого прогноза.

The authors present literature review on the important clinical issue – arterial hypertension (AH) management in patients with Type 2 diabetes mellitus (DM-2). In DM-2 individuals, AH prevalence triples, and dangerous combination of AH and DM-2 substantially increases target organ damage (TOD) risk. Analyzing various studies on causes of additional TOD risk increase, the authors conclude that blood pressure control is most important in DM-2 treatment. Clinical importance of antihypertensive agents’ metabolic effects in regard to long-term cardiovascular prognosis is discussed.

артериальная гипертониясахарный диабет 2 типаконтроль артериального давленияметаболические эффектыarterial hypertensionType 2 diabetes mellitusblood pressure controlmetabolic effectsReferencesWild S, Roglic G, Green A, et al. Global prevalence of diabetes. Estimates for the year 2000 and projections fro 2030. Diabetes Care 2004; 27:1047-53.Wild S, Roglic G, Green A, et al. Global prevalence of diabetes. Estimates for the year 2000 and projections fro 2030. Diabetes Care 2004; 27:1047-53.Salomaa VV, Strandberg TE, Vanhanen H, et al. Glucose toler- ance and blood pressure: long term follow up in middle aged men. BMJ 1991; 302: 493-6.Salomaa VV, Strandberg TE, Vanhanen H, et al. Glucose toler- ance and blood pressure: long term follow up in middle aged men. BMJ 1991; 302: 493-6.Teuscher A, Egger M, Herman JB. Diabetes and hypertension. Blood pressure in clinical diabetic patients and a control popula- tion. Arch Intern Med 1989; 149: 1942-5.Teuscher A, Egger M, Herman JB. Diabetes and hypertension. Blood pressure in clinical diabetic patients and a control popula- tion. Arch Intern Med 1989; 149: 1942-5.Baba T, Neugebauer S, Watanabe T. Diabetic nephropathy. Its relationship to hypertension and means of pharmacological intervention. Drugs 1997; 54: 197-234.Baba T, Neugebauer S, Watanabe T. Diabetic nephropathy. Its relationship to hypertension and means of pharmacological intervention. Drugs 1997; 54: 197-234.Kannel WB, Wilson PW, Zhang TJ. The epidemiology of impaired glucose tolerance and hypertension. Am Heart J 1991; 121: 1268-71.Kannel WB, Wilson PW, Zhang TJ. The epidemiology of impaired glucose tolerance and hypertension. Am Heart J 1991; 121: 1268-71.Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 1993; 16: 434-44.Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 1993; 16: 434-44.Brancati FL, Whelton PK, Randall BL, et al. Risk of end-stage renal disease in diabetes mellitus: a prospective cohort study of men screened for MRFIT: Multiple Risk Factor Intervention Trial. JAMA 1997; 278: 2069-74.Brancati FL, Whelton PK, Randall BL, et al. Risk of end-stage renal disease in diabetes mellitus: a prospective cohort study of men screened for MRFIT: Multiple Risk Factor Intervention Trial. JAMA 1997; 278: 2069-74.Assman G, Cullen P, Schulte H. Simple scoring scheme for cal- culating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. Circulation 2002; 105: 310-5.Assman G, Cullen P, Schulte H. Simple scoring scheme for cal- culating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. Circulation 2002; 105: 310-5.Poredos P. Endothelial dysfunction and cardiovascular disease. Pathophysiol Haemost Thromb 2002; 32(5-6): 274-7.Poredos P. Endothelial dysfunction and cardiovascular disease. Pathophysiol Haemost Thromb 2002; 32(5-6): 274-7.Parving HH. Initiation and progression of diabetic nephropathy. N Engl J Med 1996; 335: 1682-3.Parving HH. Initiation and progression of diabetic nephropathy. N Engl J Med 1996; 335: 1682-3.Jensen JS, Feld-Rasmussen B, Strandgaard S, et al. Arterial hypertension microalbuminuria risk of ischemic heart disease. Hypertension 2000; 35: 898-903.Jensen JS, Feld-Rasmussen B, Strandgaard S, et al. Arterial hypertension microalbuminuria risk of ischemic heart disease. Hypertension 2000; 35: 898-903.National Kidney Foundation. Executive summary. Am J Kid Dis 2004; 43(Suppl. 1): S16-33.National Kidney Foundation. Executive summary. Am J Kid Dis 2004; 43(Suppl. 1): S16-33.Arnlov J, Evans JC, Meigs JB, et al. Low-grade albuminuria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals: the Framingham Heart Study. Circulation 2005; 112: 969-75.Arnlov J, Evans JC, Meigs JB, et al. Low-grade albuminuria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals: the Framingham Heart Study. Circulation 2005; 112: 969-75.Shehadeh A, Regan TJ. Cardiac consequences of diabetes melli- tus. Clin Cardiol 1995; 18: 301-5.Shehadeh A, Regan TJ. Cardiac consequences of diabetes melli- tus. Clin Cardiol 1995; 18: 301-5.Lewington S, Clarke R, Qizilbash N, et al.; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one mil- lion adults in 61 prospective studies. Lancet 2002; 360: 1903-13.Lewington S, Clarke R, Qizilbash N, et al.; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one mil- lion adults in 61 prospective studies. Lancet 2002; 360: 1903-13.Hansson L, Zanchetti A, Carruthers SG, et al.; HOT Study Group. Effects of intensive blood-pressure lowering and low- dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351: 1755-62.Hansson L, Zanchetti A, Carruthers SG, et al.; HOT Study Group. Effects of intensive blood-pressure lowering and low- dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351: 1755-62.UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complica- tions in type 2 diabetes: UKPDS 38. BMJ 1998; 317: 703-13.UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complica- tions in type 2 diabetes: UKPDS 38. BMJ 1998; 317: 703-13.ACCORD Study Group. The ACCORD trial: a multidisciplinary approach to control cardiovascular risk in type 2 diabetes mellitus. Pract Diabetol 2004; 23: 6-11.ACCORD Study Group. The ACCORD trial: a multidisciplinary approach to control cardiovascular risk in type 2 diabetes mellitus. Pract Diabetol 2004; 23: 6-11.American Diabetes Association. Standards of medical care in diabetes: 2006. Diabetes Care 2006; 29(Suppl. 1): S4-42.American Diabetes Association. Standards of medical care in diabetes: 2006. Diabetes Care 2006; 29(Suppl. 1): S4-42.Lenfant C, Chobanian AV, Jones DW, Roccella EJ; Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7): resetting the hypertension sails. Hypertension 2003; 41: 1178-9.Lenfant C, Chobanian AV, Jones DW, Roccella EJ; Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7): resetting the hypertension sails. Hypertension 2003; 41: 1178-9.Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J 2007; 28(1): 88-136.Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J 2007; 28(1): 88-136.Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2007; 115(1): 114-26.Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2007; 115(1): 114-26.Nilsson PM, Gudbjornsdottir S, Eliasson B, Cederholm J, for the Steering Committee of the National Diabetes Register in Sweden. Hypertension in diabetes: trends in clinical control in repeated national surveys from Sweden 1996-99. J Hum Hypertens 2003; 17: 37-44.Nilsson PM, Gudbjornsdottir S, Eliasson B, Cederholm J, for the Steering Committee of the National Diabetes Register in Sweden. Hypertension in diabetes: trends in clinical control in repeated national surveys from Sweden 1996-99. J Hum Hypertens 2003; 17: 37-44.Anselmino M, Bartnik M, Malmberg K, Ryden L, on behalf of the Euro Heart Survey Investigators. Management of coronary artery disease in patients with and without diabetes mellitus. Acute management reasonable but secondary prevention unacceptably poor: a report from the Euro Heart Survey on Diabetes and the Heart. Eur J Cardiovasc Prev Rehabil 2007; 14(1): 28-36.Anselmino M, Bartnik M, Malmberg K, Ryden L, on behalf of the Euro Heart Survey Investigators. Management of coronary artery disease in patients with and without diabetes mellitus. Acute management reasonable but secondary prevention unacceptably poor: a report from the Euro Heart Survey on Diabetes and the Heart. Eur J Cardiovasc Prev Rehabil 2007; 14(1): 28-36.Моисеев В.С., Кобалава Ж.Д. Артериальная гипертония у лиц старших возрастных групп. Москва «МИА» 2002; 446 с.Моисеев В.С., Кобалава Ж.Д. Артериальная гипертония у лиц старших возрастных групп. Москва «МИА» 2002; 446 с.Curb D, Pressel SL, Cutler JA, et al. Effects of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. JAMA 1996; 276: 1886-92.Curb D, Pressel SL, Cutler JA, et al. Effects of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. JAMA 1996; 276: 1886-92.Lievre M, Gueyffier F, Ekbom T, et al.; INDANA Steering Committee. Efficacy of diuretics and beta-blockers in diabetic hypertensive patients; results from a meta-analysis. Diabetes Care 2000; 23(Suppl. 2): B65-71.Lievre M, Gueyffier F, Ekbom T, et al.; INDANA Steering Committee. Efficacy of diuretics and beta-blockers in diabetic hypertensive patients; results from a meta-analysis. Diabetes Care 2000; 23(Suppl. 2): B65-71.Tuomilehto J, Rastenyte D, Birkenhager WH, et al. Systolic hypertension in Europe Trial Investigators. Effects of calcium-channel blockade in older patients with diabetes and systolic hypertension. N Engl J Med 1999; 340: 677-84.Tuomilehto J, Rastenyte D, Birkenhager WH, et al. Systolic hypertension in Europe Trial Investigators. Effects of calcium-channel blockade in older patients with diabetes and systolic hypertension. N Engl J Med 1999; 340: 677-84.Wang JG, Staessen JA, Gong L, Liu L. Systolic Hypertension in China (Syst-China) Collaborative Group. Chinese trial on isolated systolic hypertension in the elderly. Arch Intern Med 2000; 160: 211-20.Wang JG, Staessen JA, Gong L, Liu L. Systolic Hypertension in China (Syst-China) Collaborative Group. Chinese trial on isolated systolic hypertension in the elderly. Arch Intern Med 2000; 160: 211-20.Yusuf S, Sleight P, Pogue J, et al.; Heart Outcomes Prevention Evaluation Study Investigators. Effects on an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145-53.Yusuf S, Sleight P, Pogue J, et al.; Heart Outcomes Prevention Evaluation Study Investigators. Effects on an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145-53.Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253-9.Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253-9.Turnbull F, Neal B, Algert C, et al.; Blood Pressure Lowering Trialists’ Collaboration. Effects of different blood pressure-lowering regimens on major cardiovascular events in individuals with and without diabetes mellitus: results of prospectively designed overviews of randomized trials. Arch Intern Med 2005; 165: 1410-9.Turnbull F, Neal B, Algert C, et al.; Blood Pressure Lowering Trialists’ Collaboration. Effects of different blood pressure-lowering regimens on major cardiovascular events in individuals with and without diabetes mellitus: results of prospectively designed overviews of randomized trials. Arch Intern Med 2005; 165: 1410-9.Estacio RO, Jeffers BW, Hiatt WR, et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med 1998; 338: 645-52.Estacio RO, Jeffers BW, Hiatt WR, et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med 1998; 338: 645-52.Tatti P, Pahor M, Byington RP, et al. Outcome results of the Fosinopril versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998; 21: 597-603.Tatti P, Pahor M, Byington RP, et al. Outcome results of the Fosinopril versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998; 21: 597-603.Niskanen L, Hedner T, Hansson L, et al. Reduced cardiovascular morbidity and mortality in hypertensive diabetic patients on first-line therapy with an ACE inhibitor compared with a diuretic / beta-blocker-based treatment regimen: a subanalysis of the Captopril Prevention Project. Diabetes Care 2001; 24: 2091-6.Niskanen L, Hedner T, Hansson L, et al. Reduced cardiovascular morbidity and mortality in hypertensive diabetic patients on first-line therapy with an ACE inhibitor compared with a diuretic / beta-blocker-based treatment regimen: a subanalysis of the Captopril Prevention Project. Diabetes Care 2001; 24: 2091-6.Ruggenenti P, Fassi A, Ilieva AP, et al.; Brugesan Bergamo Nephrologic Diabetes complications Trial (BENEDICT) Investigators. Preventing microalbuminuria in type 2 diabetes. N Engl J Med 2004; 1941-51.Ruggenenti P, Fassi A, Ilieva AP, et al.; Brugesan Bergamo Nephrologic Diabetes complications Trial (BENEDICT) Investigators. Preventing microalbuminuria in type 2 diabetes. N Engl J Med 2004; 1941-51.Varughese GI, Lip GY. Antihypertensive therapy in diabetes mellitus: insights from ALLHAT and the Blood Pressure-Lowering Treatment Trialists’ Collaboration meta-analysis. J Hum Hypertens 2005; 19: 851-3.Varughese GI, Lip GY. Antihypertensive therapy in diabetes mellitus: insights from ALLHAT and the Blood Pressure-Lowering Treatment Trialists’ Collaboration meta-analysis. J Hum Hypertens 2005; 19: 851-3.Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253-9.Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253-9.Strippoli G, Craig M, Deeks J, еt al. Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy: systematic review. BMJ 2004; 329: 828.Strippoli G, Craig M, Deeks J, еt al. Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy: systematic review. BMJ 2004; 329: 828.Hansson L, Lindholm LH, Niskanen L, et al. Effect of angiotensin-converting-enzyme inhibitor compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPP) randomized trial. Lancet 1999; 353: 611-6.Hansson L, Lindholm LH, Niskanen L, et al. Effect of angiotensin-converting-enzyme inhibitor compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPP) randomized trial. Lancet 1999; 353: 611-6.The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981-97.The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981-97.Gillespie EL, White CM, Kardas M, et al. The impact of ACE inhibitors or angiotensin II type 1 receptor blockers on the development of new-onset type 2 diabetes. Diabetes Care 2005; 28(9): 2261-6.Gillespie EL, White CM, Kardas M, et al. The impact of ACE inhibitors or angiotensin II type 1 receptor blockers on the development of new-onset type 2 diabetes. Diabetes Care 2005; 28(9): 2261-6.Jandeleit-Dahm KA, Tikellis C, Reid CM, et al. Why blockade of the rennin-angiotensin system reduces the incidence of new-onset diabetes. J Hypertens 2005; 23(3): 463-73.Jandeleit-Dahm KA, Tikellis C, Reid CM, et al. Why blockade of the rennin-angiotensin system reduces the incidence of new-onset diabetes. J Hypertens 2005; 23(3): 463-73.Mancia G, Grassi G, Zanchetti A. New-onset diabetes and antihypertensive drugs. J Hypertens 2006; 24(1): 3-10.Mancia G, Grassi G, Zanchetti A. New-onset diabetes and antihypertensive drugs. J Hypertens 2006; 24(1): 3-10.Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007; 369: 201-7.Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007; 369: 201-7.DREAM Trial Investigators. Effect of ramipril on the incidence of diabetes. N Engl J Med 2006; 355(15): 1551-62.DREAM Trial Investigators. Effect of ramipril on the incidence of diabetes. N Engl J Med 2006; 355(15): 1551-62.Whelton PK, Barzilay J, Cushman WC, et al. Clinical outcomes in antihypertensive treatment of type 2 diabetes, impaired fasting glucose concentration and normoglycaemia: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trail (ALLHAT). Arch Intern Med 2005; 165: 1401-9.Whelton PK, Barzilay J, Cushman WC, et al. Clinical outcomes in antihypertensive treatment of type 2 diabetes, impaired fasting glucose concentration and normoglycaemia: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trail (ALLHAT). Arch Intern Med 2005; 165: 1401-9.Williams B, Lacy PS, Thom SM, et al.; CAFE Investigators, Anglo-Scandinavian Cardiac Outcomes Trial Investigators, CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) Study. Circulation 2006; 7: 1213-25.Williams B, Lacy PS, Thom SM, et al.; CAFE Investigators, Anglo-Scandinavian Cardiac Outcomes Trial Investigators, CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) Study. Circulation 2006; 7: 1213-25.Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011-53.Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011-53.Kaplan NM. Management of hypertension in patients with type 2 diabetes mellitus: guidelines based on current evidence. Ann Intern Med 2001; 135: 1079-83.Kaplan NM. Management of hypertension in patients with type 2 diabetes mellitus: guidelines based on current evidence. Ann Intern Med 2001; 135: 1079-83.Mogensen CE, Viberti G, Halini S, et al. Effect of low dose of perindopril/indapamide on albuminuria in diabetes (PRE- MIER). Hypertension 2003; 41: 1063-71.Mogensen CE, Viberti G, Halini S, et al. Effect of low dose of perindopril/indapamide on albuminuria in diabetes (PRE- MIER). Hypertension 2003; 41: 1063-71.Bakris GL, Gaxiola E, Messerli FH, et al.; INVEST Investigators. Clinical outcomes in the diabetes cohort of the INternational VErapamil SR-Trandolapril study. Hypertension 2004; 44: 637-42.Bakris GL, Gaxiola E, Messerli FH, et al.; INVEST Investigators. Clinical outcomes in the diabetes cohort of the INternational VErapamil SR-Trandolapril study. Hypertension 2004; 44: 637-42.Chalmers J, Perkovic V, Joshi R, Patel A. ADVANCE: breaking new ground in type 2 diabetes. J Hypertens Suppl 2006; 24(5): S22-8.Chalmers J, Perkovic V, Joshi R, Patel A. ADVANCE: breaking new ground in type 2 diabetes. J Hypertens Suppl 2006; 24(5): S22-8.

The authors declare that there are no conflicts of interest present.