Management of Hypertension in Diabetic Patients With Chronic Kidney Disease

Susan Steigerwalt, MD, FACP Diabetes is associated with markedly increased cardiovascular risk, a risk compounded with imposition of chronic kidney disease (CKD). More than 80% of people with diabetes and CKD have hypertension, and many have an obliterated nocturnal blood pressure “dip,” the normal physiological drop in blood pressure during sleep. Appropriate blood pressure measurement is the Achilles heel of hypertension management, especially in diabetic kidney disease (DKD). This review elaborates on the evidence regarding one of the most important therapeutic targets in DKD, namely, control of blood pressure to < 130/80 mmHg, and provides detailed information about appropriate blood pressure measurement and treatments to best achieve that target. In Brief