Hypertension affects more than 70% of patients with type 2 diabetes mellitus and further increases the risk of cardiovascular disease in this high-risk population.1 While renin angiotensin system (RAS) blockers are clearly indicated in patients with heart failure, chronic kidney disease with proteinuria, and coronary artery disease (CAD), experts have come to different conclusions regarding their role as initial antihypertensive therapy for patients with diabetes.
About 5 million Americans are currently living with heart failure (HF) and an astounding 24-42% also suffer from depression. One meta-analysis found a greater than 2-fold risk of death in patients with HF and comorbid depression. Depressed patients with HF are more likely to be hospitalized, seek care from emergency rooms, and rack up big bills. Not surprisingly, patients with HF and depression have a much lower quality of life when compared to HF patients without depression. Clearly, this is BIG problem. But can we do anything about it?