1. Step Care Therapy for Hypertension in Diabetic Patients
Joseph L. Blackshear, MD, Gary L. Schwartz, MD 
Mayo Clinic Proceedings 
Volume 76, Issue 12, Pages (December 2001)
DOI: /
Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions

2. Figure 1
General algorithm for management of hypertension in diabetic patients.
*In many patients with congestive heart failure (CHF) due to left ventricular systolic dysfunction, diuretics will already have been prescribed to treat symptoms of fluid overload. Angiotensin-converting enzyme (ACE) inhibitors and β-blockers should then be added for further improvement of symptoms and survival. As noted in the footnote to Table 3, combined β-blocker and ACE inhibitor therapy is likely indicated in patients with known coronary artery disease (CAD), diabetes, and a clear indication for β-blocker use. ARB = angiotensin receptor blocker; BP = blood pressure; MI = myocardial infarction.
†If management of proteinuria is a priority, diltiazem or verapamil may be substituted for the ACE inhibitor and diuretic.
Mayo Clinic Proceedings  , DOI: ( / )
Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions