Diabetes JNC VI recommends that beta-blockers be given to only those diabetics with specific indications such as coronary heart disease. JNC VI also recommends that ACE inhibitors be used by diabetics who have proteinuria. Consequently, most hypertension specialists now recommend that beta-blockers can also be prescribed for diabetics who don't have complications. The point is to get a patient's blood pressure down. The available data now indicate that beta-blockers can be a useful tool in that effort for a wider group of diabetics.
Hypertension is a major risk factor for many serious health problems.
Yet, as many as half the patients who start hypertension treatment stop within a year. What the JNC VI guidelines and recent studies demonstrate is that aggressive attention to high blood pressure reduces morbidity and mortality and improves quality of life. Because of the continuity they have in their relationships with patients, primary care physicians are uniquely positioned to deliver the ongoing reinforcement that is as important as the hypertension treatment itself. Dr. Sheps is professor emeritus of medicine at the Mayo Clinic, Rochester, MN, and was chair of the JNC VI guidelines committee. Andrew A. Skolnick, a medical writer in Chicago, IL, contributed to the researching and writing of this article.