Management of Hypertension in Patients with T2DM

Antihypertensive Therapy

The American College of Cardiology recommends switching from felodipine to amlodipine due to its similar antihypertensive efficacy but fewer side effects such as dizziness, headache, and flushing 1
The American Heart Association suggests continuing losartan 100mg daily as it is well tolerated by the patient, with a consideration to add a thiazide-like diuretic (chlorthalidone 12.5-25mg daily) as a third agent if blood pressure remains uncontrolled 2, 3
Chlorthalidone is preferred based on its prolonged half-life and proven cardiovascular disease reduction, according to the American Heart Association 3

The American Diabetes Association recommends continuing to monitor HbA1c as the patient has shown improvement in glycemic control, in addition to managing sciatica pain with gabapentin and considering physical therapy referral for recurrent sciatica pain 4
The American Heart Association suggests avoiding non-dihydropyridine calcium channel blockers (diltiazem, verapamil) in patients with diabetes due to potential negative effects on cardiac function 6

The American Heart Association recommends monitoring renal function regularly as the patient is on both an ARB (losartan) and potentially adding a diuretic, and assessing for orthostatic hypotension when initiating amlodipine 3
The American College of Cardiology suggests that if the patient develops peripheral edema with amlodipine, consider dose reduction 1, 3