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L.N. is a 49-year-old white woman with a history of type 2 diabetes, obesity, hypertension, and migraine headaches. The patient was diagnosed with type 2 diabetes 9 years ago when she presented with mild polyuria and polydipsia. L.N. is 5\u20324\u2033 and has always been on the large side, with her weight fluctuating between 165 and 185 lb.<\/p>\n

Initial treatment for her diabetes consisted of an oral sulfonylurea with the rapid addition of metformin. Her diabetes has been under fair control with a most recent hemoglobin A1c of 7.4%.<\/p>\n

Hypertension was diagnosed 5 years ago when blood pressure (BP) measured in the office was noted to be consistently elevated in the range of 160\/90 mmHg on three occasions. L.N. was initially treated with lisinopril, starting at 10 mg daily and increasing to 20 mg daily, yet her BP control has fluctuated.<\/p>\n

One year ago, microalbuminuria was detected on an annual urine screen, with 1,943 mg\/dl of microalbumin identified on a spot urine sample. L.N. comes into the office today for her usual follow-up visit for diabetes. Physical examination reveals an obese woman with a BP of 154\/86 mmHg and a pulse of 78 bpm.<\/p>\n

Questions<\/p>\n

What are the effects of controlling BP in people with diabetes?<\/p>\n

What is the target BP for patients with diabetes and hypertension?<\/p>\n

Which antihypertensive agents are recommended for patients with diabetes?<\/p>\n \n

\"Looking for a Similar Assignment? Order now and Get 10% Discount! Use Code \"Newclient\"<\/h5>\n\"\"<\/a>\n\n","protected":false},"excerpt":{"rendered":"

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