Tratamiento de la hipertensión arterial en la diabetes tipo 2: importancia de la selección terapéutica
DOI:
https://doi.org/10.31053/1853.0605.v62.n3.32473Palabras clave:
Hipertensión arterial, Diabetes tipo 2, Selección terapéuticaResumen
ANTECEDENTES: La hipertensión y la diabetes son las causas irias comunes de insuficiencia renal terminal en Argentina. Sobre 887 transplantes de órganos efectuados en el año 2004, correspondieron 577 a transplantes renales. En poblaciones urbanas y rurales argentinas la hipertensión tiene una prevalencia mas alta en diabéticos, siendo el tipo mas frecuente la hipertensión sistólica. Los estudios sobre la evolución se utilizan para estimar los puntos finales altamente significativos desde la perspectiva clínica. Ni ies tras conocimientos actuales sobre los efectos riel tratamiento de la hipertensión en la diabetes tipo 2 se fundan en los resultados obtenidos en estudios longitudinales randomizados. AMBITO: El presente trabajo, basado sobre una bósqiteda en el periodo 1990-2005 de la literatura MEDLINE, revisa los estudios randoinizados con el objetivo de determinar cuales son las mejores estrategias terapéuticas en esta asociación mórbida. La mayoría de los pacientes requieren dos a cuatro drogas antihipertensivas para enlentecer la progresión de daño de órganos nobles. La elección inicial de las drogas a utilizar debería fundarse sobre la presencia o no de complicaciones en órganos blanco. En aquellos pacientes sin evidencias de complicaciones, el objetivo primario es alcanzar niveles de PA <130/80 mm Hg, mas allá de las diferencias que existen entre las distintas clases de fármacos, mientras que en aquellos con afectaciones de órgano blanco se requiere mantener la PA en <120/75 mm Hg.
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