ENFERMEDAD CARDIOVASCULAR EN PACIENTES CON ENFERMEDAD RENAL POR DIABETES

Guillermo Dieuzeide

Resumen


La mayoría de los pacientes con diabetes e hipertensión debería tratarse con un objetivo de tensión arterial sistólica <140 mmHg yTA diastólica de <90 mmHg. Menores valores deTA <130/80 mmHg pueden ser adecuados en pacientes con alto riesgo de enfermedad cardíaca y renal. Inhibidores de enzima convertidora de angiotesina (IECA) o bloqueadores del receptor angiotensina (ARA II) a dosis máxima tolerada se consideran drogas de primera línea en el tratamiento de la hipertensión arterial; en pacientes diabéticos con un índice albuminuria/creatininuria >30 mg/g la creatinina sérica, el nivel de filtración glomerular y el nivel de potasio deben ser monitoreados. Diferentes estudios  observan con estas drogas nefroprotección independientemente de la dis- minución de la presión arterial alcanzada. No se recomienda utilizar una combinación de IECA con ARA II. Los inhibidores de los canales de calcio son drogas seguras para el tratamiento de la hipertensión arterial en pacientes diabéticos con insuficiencia renal.


Palabras clave


enfermedad aterosclerótica cardiovascular; tensión arterial; inhibidores de enzima convertidora de angiotesina; bloqueadores del receptor angiotensina; inhibidores de canales de calcio; nefroprotección

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DOI: http://dx.doi.org/10.47196/diab.v51i3.111