Which of the following statements about hypertension in diabetes patients is/are correct?

A. Hypertension worsens the macrovascular disease of diabetes patients.

B. Hypertension accelerates the progression of diabetic nephropathy.

C. Hypertension is associated with sodium retention in diabetes patients.

D. Angiotensin-converting enzyme (ACE) inhibitors should be used in all patients with chronic hyperglycemia, regardless of the presence of hypertension.

E. Diuretics, as single-drug therapy, are not indicated in the treatment of hypertension in diabetes patients. Answer: ABCDE

DISCUSSION: All of the answers listed are correct. By damaging endothelial cells, hypertension worsens macrovascular disease in all patients but especially in diabetics. Hypertension dramatically accelerates the onset and progression of diabetic renal disease and proteinuria, and this phenomenon can be slowed or prevented by a combination of treatment modalities, including ACE inhibitors, which dilate efferent glomerular vessels and lower intraglomerular pressure. Despite sodium retention in diabetes patients, single-drug therapy with a diuretic is not indicated because the chronic state of dehydration in such patients may become worse.