SciELO - Scientific Electronic Library Online

vol.17 issue1Study of the coronary sinus and its tributaries in colombian subjectsHypertension treatment in patients with metabolic syndrome author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Revista Colombiana de Cardiología

Print version ISSN 0120-5633


LAHERA, Vicente  and  FERNANDEZ, Sandra L. Integrated management of hypertensive patients with metabolic syndrome and diabetes. Rev. Colom. Cardiol. [online]. 2010, vol.17, n.1, pp.16-21. ISSN 0120-5633.

In the last years an increase in the prevalence of obesity and metabolic syndrome has been observed around the world. Causes for this increase are mainly related with sedentarism and inadequate diet. Obesity and metabolic syndrome are a primary cause for the development of cardiovascular disease and type 2 diabetes mellitus. Furthermore, insulin resistance plays a central role in the development of vascular and metabolic alterations associated with metabolic syndrome and obesity: atherogenic dyslipidemia, hypertension, pro-thrombotic and inflammatory states. Activation of sympathetic nervous system and renin-angiotensin-aldosterone system play a main role in the majority of these alterations. Thus, blockade of angiotensin II actions with ACEis or ARA II is an obligatory therapeutical approach for these type of patients. It has to be considered that many patients with multiple risk factors need more than one drug to control hypertension. Combination of drugs blocking angiotensin II with diuretics is the most common combination. However, due to the diabetogenic potential of thiazidic diuretics, this combination is not the most appropriate for hypertensive patients with diabetes, metabolic syndrome or alterations of glucose metabolism. Consequently, the combinations of ACEIs with calcium antagonists has revealed as an interesting alternative combination. ACCOMPLISH, STAR and STAR-LET studies, demonstrated important benefits in diabetic patients or in patients with insulin resistance.

Keywords : obesity; metabolic syndrome; diabetes; angiotensin converting enzyme inhibitors; calcium antagonists.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License