Treating Hypertension in Diabetic Nephropathy

Treating Hypertension in Diabetic Nephropathy Jeremy W. Tomlinson , MRCP , Katharine R. Owen , MRCP and Colin F. Close , MD From the Department of Diabetes, Taunton and Somerset Hospital, Taunton, U.K. Abstract OBJECTIVE —Control of hypertension in patients with diabetic nephropathy improves mortality and slows progression to end-stage renal disease. However, blood pressure is difficult to treat; multiple drug combination therapy is required and treatment algorithms to establish this are lacking. We used a stepped-care algorithm, centered on maximum doses of an ACE inhibitor or angiotensin II receptor blocker, to treat hypertension according to American Diabetes Association recommended blood pressure target goals (