Treatment of hypertension with diabetes mellitus in the elderly

摘要

Several factors have contributed to induce the impairment of glucose tolerance in the elderly. Especially, the changes of body composition with aging, the loss of skeletal muscle mass and relatively increased fat tissues, could occur the insulin resistant state. Such states would be well known to accompany with diabetes mellitus and hypertension. Therefore, the treatment of hypertension with diabetes in the elderly could be very important to prevent not only microangiopathy but also macroangiopathy. The optimal blood pressure levels to reduce hypertension-related morbidity and mortality in diabetic elderly have been proposed 130/85 in JSH2000. The first step therapy in this case would be recommended calcium channel blocker, angiotensin-converting enzyme inhibitor and angiotensin receptor blocker. In addition, comprehensive geriatric assessment must be important to maintain drug compliance for well-controlled blood pressure levels.