Interactive diabetes case 20: A 76-year-old patient with longstanding type 2 diabetes, orthostatic hypotension, and recurrent syncope – C1

ANSWER — 

Incorrect.

In most patients with diabetes, especially those with kidney disease, it is appropriate to reduce the office systolic blood pressure to 125 to 130 mmHg if this can be achieved without a reduction in the diastolic pressure to <55 to 60 mmHg in older adults with orthostatic hypotension (see "Treatment of hypertension in older adults, particularly isolated systolic hypertension"). On the other hand, there are no outcome studies that tell us the benefits and risks of treating supine hypertension in a patient with autonomic orthostatic hypotension. While it is sometimes necessary to accept supine systolic hypertension in this setting, simple measures may reduce the supine systolic values and the cardiovascular risks of systolic hypertension.

Return to the previous choice to try again. (See "Interactive diabetes case 20: A 76-year-old patient with longstanding type 2 diabetes, orthostatic hypotension, and recurrent syncope – B3".)