Skip to main content
Home
Browse topics
Cardiovascular disorders Chronic kidney disease Diabetes devices & technology GLP-1 receptor agonists Hyperglycemia Hypoglycemia Obesity, diet, & lifestyle interventions SGLT2 inhibitors Type 1 diabetes Type 2 diabetes Browse all topics
EN
EN
In focus
Novel clinical evidence in continuous glucose monitoring Fasting for religion and health in people with diabetes The challenge of type 2 diabetes in children HFpEF & diabetes: Diagnosis and management in the wake of EMPEROR-Preserved Addressing suicide risk in diabetes: Rates and risk factors, HCP fears, and practical advice The SURPASS trials: Summarizing efficacy data on tirzepatide Semaglutide for weight loss: STEP and SELECT trials: Results from the STEP and SELECT trials Why psychosocial care matters DiRECT: Type 2 diabetes remission through weight management
Congress coverage
EASD 58th Annual Meeting 2022 The American Diabetes Association 82nd Scientific Sessions
About us
Medicine Matters Diabetes
EXTENDED SEARCH

Video+

Ask the expert

Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).



Learning points include:

  • The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
  • The importance of incorporating understanding of key comorbidities into treatment planning, including:
    • Left ventricular and/or diastolic dysfunction
    • Chronic kidney disease 
    • Benign prostatic hyperplasia
    • Heart failure
  • Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
  • The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
  • Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
  • Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
  • Best practice for avoiding adverse drug events in the acute setting.
  • The challenges associated with treating concomitant heart failure in older adults.

« Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure

Editorial Board member Jay Shubrook talks to treatment individualization specialist David Strain about the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:40).


Learning points include:

  • The ways in which older adults are physiologically distinct from other populations and considerations for appropriate care based on anticipated lifestyle.
  • Expectations for systolic and diastolic blood pressure changes in older adults as well as the impacts they have on cardiovascular health.
  • The importance of specific measures including: pulse pressure, arterial compliance.
  • Risk factors associated with low diastolic blood pressure (<75mmHg) and prospective antihypertensive treatment strategies that may mitigate such risks.

 

« Video 3: When to intervene in patients with diabetes and high blood pressure?



Video 5: Diabetes and blood pressure in the elderly: Which medications to use when; tips for achieving target »

 

Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton get together once more to discuss best practice tips for identifying and treating hypertension in patients with pre-existing diabetes (12:17).



Learning points include:

  • Strategies to avoid common pitfalls when performing blood pressure measurements.
  • The importance of the blood pressure measurements in determining the risk of cardiovascular events.
  • The benefits of dual-action and preload-targeted therapies in hypertensive patients.
  • Why potassium levels are an important factor to consider before initiating treatment.

« Video 2: Why aren't we reaching blood pressure goals, despite the raised target?



Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure »

In the wake of the revised blood pressure targets, recommended by the American Diabetes Association's 2017 Position Statement and 2018 Standards of Care, Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton discuss clinical approaches to get hypertensive diabetes patients to target more consistently (12:29).


Learning points include:

  • The atherogenic risk posed by diabetes and why blood pressure measurements from the arm-alone may not be sufficient to evaluate the threat in all patients.
  • The benefits and drawbacks of the medication classes indicated for hypertension treatment, such as:
    • Diuretics
    • β-blockers
    • Calcium channel blockers
  • The impact and rationale for targeting blood pressures lower than those indicated in the ADA position statement. 

« Video 2: What are the current recommendations for managing high blood pressure in diabetes patients?



Video 3: When to intervene in patients with diabetes and high blood pressure? »

Image Credits