Management of Heartburn in Diabetic and Hypertensive Patients

Pharmacological Therapy for Heartburn

• The American Diabetes Association recommends that patients with diabetes and hypertension should already be treated with an ACE-inhibitor or an angiotensin receptor blocker (ARB) as first-line therapy for hypertension 1, 2, 3
• The American Diabetes Association suggests that the blood pressure target should be <130/80 mmHg, and if the patient has not reached this target with monotherapy, consideration should be given to adding a thiazide-like diuretic and/or a dihydropyridine calcium channel blocker 3, 5
• The American Heart Association recommends that patients with hypertension should lose weight if they are overweight or obese, follow a DASH-style diet with reduced sodium intake (1200-2300 mg/day), increase consumption of fresh fruits, vegetables, and low-fat dairy products, engage in at least 150 minutes of moderate-intensity aerobic activity per week, limit alcohol consumption (maximum one drink per day for women, two for men) 4

Monitoring and Follow-up

• The American Diabetes Association recommends monitoring renal function and serum potassium levels within 3 months of starting therapy with ACE-inhibitors, ARBs, or diuretics, and then every 6 months if stable 3, 4