Abstract
Essential hypertension represents a very heterogenous group of diseases and in the short future could be differentiated to new types of secondary arterial hypertension (AH); e.g. AH in patients with insulin resistence, i.e. in cardiometabolic syndrome or type 2 diabetes mellitus could be one of them.
Prehypetension or rather high normal blood pressure (BP 130/85 - 139/89 mmHg) is in positive association with high risk of AH and type 2 diabetes, but pharmacological management of prehypertension is still an unresolved problem. Pharmacological treatment of AH in patients with prediabetes or diabetes is considered a very important approach for the reduction of cardiovascular risk and risk for microvascular complications, especially diabetic nephropathy and renal failure.
The chioce of suitable antihypertensive drugs (RAS inhibitors, esp. ACE inhibitors alone or in combination with calcium channel blockers, metabolic neutral diuretics or central acting antihypertenssive drugs), sufficient doses and good patients compliance to the recommended non-pharmacological and pharmacological treatment represent the most important conditions for successful management of AH in prediabetic or diabetic patients.