More aggressive treatment urged for diabetics with high blood pressure

CHICAGO - The National Kidney Foundation is urging more aggressive treatment of diabetics with high blood pressure.

Blood pressure in such patients should be no higher than 130 over 80, the foundation said. The current standard is under 130 over 85.

Most of the more than 11 million Americans with both diabetes and high blood presssure will need to take at least two drugs to reach the lower target rate, according to the foundation. The foundation also recommended that treatment start with an ACE inhibitor, a common type of medication.

The guidelines, published in September's American Journal of Kidney Diseases, are based on recent research suggesting that diabetics who have high blood pressure with a diastolic reading - the bottom number - of around 80 have fewer cardiovascular complications and less kidney failure.

Diabetics are more vulnerable to heart attacks and life-threatening kidney failure.

High blood pressure in a diabetic ''is like adding gasoline to the fire,'' said Dr. George Bakris, who led a National Kidney Foundation committee that created the recommendations.

The foundation's report was funded in part by Novartis Pharmaceuticals Corp., a maker of blood pressure medications, including ACE inhibitors.

Despite the recommendation, the American Diabetes Association stands by the higher threshold and believes it is not only safe but more achievable, said Dr. Richard Kahn, ADA chief scientific and medical officer.

The new guidelines do not apply to the general population, for whom the recommended blood pressure remains less than 140 over 90.

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On the Net:

National Kidney Foundation: http://www.kidney.org

National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/hbp/resources/diabetes-statement.html