REVIEW ARTICLES

Pharmacotherapy Of Hypertension And Diabetes Co-Morbidity In The Elderly

A Narrative Review
Akponah Erhiori 1
Moke EG
Elijah OB
Ovili-Odili BZ
Ekakitie LI
Ben-Azu B
Ilevbare F
Imolede OI

1Delta State University

DOI: 10.4314/ajtmbr.v9i1.%x
Published: July 31, 2026

Abstract

Introduction: Ageing is a normal physiological process, and with improving healthcare and standard of living, the elderly population is projected to increase substantially over time. Hypertension occurs in up to 80% of type 2 diabetes cases, and co-morbidity between the two conditions is common among the elderly, posing significant challenges in clinical management. If not adequately addressed, this co-morbidity can lead to increased mortality and complications such as retinopathy, neuropathy and nephropathy.

Materials and Methods: This narrative review searched Google Scholar, ResearchGate, PubMed and Scopus for literature on the pharmacotherapy of hypertension and diabetes co-morbidity published up to May 2025. A total of 117 articles meeting the inclusion criteria were selected and analysed.

Results: The review describes the pathophysiology of and interactions between hypertension and diabetes, the complications arising from their co-morbidity, and the clinical guidelines and pharmacological strategies used in their management. Treating elderly patients with both conditions requires a nuanced, multidisciplinary approach, as age-associated alterations in drug metabolism, polypharmacy, frailty and comorbid conditions must all be considered to avoid adverse outcomes and promote adherence while ensuring optimal efficacy.

Conclusion: Effective management of hypertension and diabetes co-morbidity in the elderly requires individualised, multidisciplinary care guided by current clinical guidelines, with emerging approaches such as personalised medicine and telemedicine offering promise for improving outcomes in this population.

Keywords

pharmacotherapy Hypertension diabetes mellitus

menu_book References

  1. Zhao J, Han Z, Ding L, Wang P, He X, Lin L. The molecular mechanism of aging and the role in neurodegenerative diseases. Heliyon. 2024; 10(2):e24751.
  2. Gu D, Andreev K, Dupre ME. Major Trends in Population Growth Around the World. China CDC Wkly. 2021; 3(28):604-613.
  3. Martinez R, Lloyd-Sherlock P, Soliz P, Ebrahim S, Vega E, Ordunez P, et al. Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990-2017: a population-based study. Lancet Glob Health. 2020; 8(4):e511-e523.
  4. de Boer IH, Bangalore S, Benetos A, Davis AM, Michos ED, Muntner P, et al. Diabetes and Hypertension: A Position Statement by the American Diabetes Association. Diabetes Care. 2017; 40(9):1273-1284.
  5. Jia G, Sowers JR. Hypertension in Diabetes: An Update of Basic Mechanisms and Clinical Disease. Hypertension. 2021; 78(5):1197-1205.
  6. Taheri A, Khezri R, Dehghan A, Rezaeian M, Aune D, Rezaei F. Hypertension among persons with type 2 diabetes and its related demographic, socioeconomic and lifestyle factors in the Fasa cohort study. Sci Rep. 2024; 14(1):e18892.
  7. Jobe M, Mactaggart I, Bell S, Kim MJ, Hydara A, Bascaran C, et al. Prevalence of hypertension, diabetes, obesity, multimorbidity, and related risk factors among adult Gambians: a cross-sectional nationwide study. Lancet Glob Health. 2024; 12(1):e55-e65.
  8. Al-Musawe L, Torre C, Guerreiro JP, Rodrigues AT, Raposo JF, Mota-Filipe H, et al. Polypharmacy, potentially serious clinically relevant drug-drug interactions, and inappropriate medicines in elderly people with type 2 diabetes and their impact on quality of life. Pharmacol Res Perspect. 2020; 8(4):e00621.
  9. Atlas. IDF Diabetes Atlas. 9th ed. International Diabetes Federation, 2019.
  10. Katsimardou A, Imprialos K, Stavropoulos K, Sachinidis A, Doumas M, Athyros VG. Treatment strategies for hypertension in patients with type 1 diabetes. Expert Opin Pharmacother. 2020; 21(10):1241-1252.
  11. Tuomilehto J, Rastenyte D, Qiao Q, Barengo NC, Matz K. Epidemiology of macrovascular disease and hypertension in diabetes mellitus. Int Textbook of Diabetes Mellitus; 2015:1005-1030.
  12. Avogaro A, Fadini GP. Microvascular complications in diabetes: A growing concern for cardiologists. Int J Cardiol. 2019; 291:29-35.
  13. Lu WL, Yuan JH, Liu ZY, Su ZH, Shen YC, Li SJ, et al. Worldwide trends in mortality for hypertensive heart disease from 1990 to 2019 with projection to 2034: data from the Global Burden of Disease 2019 study. Eur J Prev Cardiol. 2024; 31(1):23-37.
  14. International Diabetes Federation (IDF). IDF Diabetes Atlas, 10th edn. Brussels, Belgium: International Diabetes Federation, 2021. Available from: https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf
  15. Moke EG, Onyilo PO, Umukoro EK, Awhin EP, Ben-Azu B, Asiwe JN, et al. Efficacy evaluation of contemporary and alternative medicine in managing diabetes mellitus: A review. Orapuh Journal. 2025; 6(1):e1203.
  16. Brown TT, Guaraldi G. Multimorbidity and Burden of Disease. Interdiscip Top Gerontol Geriatr. 2017; 42:59-73.
  17. Ciumărnean L, Milaciu MV, Negrean V, Orăan OH, Vesa SC, Sălăgean O, et al. Cardiovascular Risk Factors and Physical Activity for the Prevention of Cardiovascular Diseases in the Elderly. Int J Environ Res Public Health. 2021; 19(1):e207.
  18. Dai X, Hummel SL, Salazar JB, Taffet GE, Zieman S, Schwartz JB. Cardiovascular physiology in the older adults. J Geriatr Cardiol. 2015; 12(3):196-201.
  19. Cleasby ME, Jamieson PM, Atherton PJ. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J Endocrinol. 2016; 229(2):R67-81.
  20. Kitada M, Koya D. Autophagy in metabolic disease and ageing. Nat Rev Endocrinol. 2021; 17(11):647-661.
  21. Sinclair AJ, Abdelhafiz AH. Multimorbidity, Frailty and Diabetes in Older People-Identifying Interrelationships and Outcomes. J Pers Med. 2022; 12(11):1911.
  22. Carracedo J, Alique M, Vida C, Bodega G, Ceprián N, Morales E, et al. Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence. Front Cell Dev Biol. 2020; 8:185.
  23. Akkus G, Sert M. Diabetic foot ulcers: A devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities. World J Diabetes. 2022; 13(12):1106-1121.
  24. Zhou D, Xi B, Zhao M, Wang L, Veeranki SP. Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study. Sci Rep. 2018; 8(1):e9418.
  25. Kim J, Parish AL. Polypharmacy and Medication Management in Older Adults. Nurs Clin North Am. 2017; 52(3):457-468.
  26. Mardani A, Paal P, Weck C, Jamshed S, Vaismoradi M. Practical Considerations of PRN Medicines Management: An Integrative Systematic Review. Front Pharmacol. 2022; 13:e759998.
  27. de Sousa FG, Queiroz FSF, Muzzi RAL, Veado JCC, Beier SL. Systemic Arterial Hypertension and Factors Associated with Blood Pressure Dysregulation in Companion Animals. Vet Sci. 2025; 12(5):e453.
  28. Wiig H, Luft FC, Titze JM. The interstitium conducts extrarenal storage of sodium and represents a third compartment essential for extracellular volume and blood pressure homeostasis. Acta Physiol (Oxf). 2018; 222(3).
  29. AlMarabeh S, Abdulla MH, O'Halloran KD. Is Aberrant Reno-Renal Reflex Control of Blood Pressure a Contributor to Chronic Intermittent Hypoxia-Induced Hypertension? Front Physiol. 2019; 10:465.
  30. Bie P. Mechanisms of sodium balance: total body sodium, surrogate variables, and renal sodium excretion. Am J Physiol Regul Integr Comp Physiol. 2018; 315(5):R945-R962.
  31. Díaz-Morales N, Baranda-Alonso EM, Martínez-Salgado C, López-Hernández FJ. Renal sympathetic activity: A key modulator of pressure natriuresis in hypertension. Biochem Pharmacol. 2023; 208:115386.
  32. Bernal A, Zafra MA, Simón MJ, Mahía J. Sodium Homeostasis, a Balance Necessary for Life. Nutrients. 2023; 15(2):395.
  33. Steckelings UM, Unger T. The Renin-Angiotensin-Aldosterone System. In: Manual of Hypertension of the European Society of Hypertension, 3rd ed., pp. 101-108. CRC Press, 2019.
  34. Nishiyama A, Kobori H. Independent regulation of renin-angiotensin-aldosterone system in the kidney. Clin Exp Nephrol. 2018; 22(6):1231-39.
  35. Lerman LO, Kurtz TW, Touyz RM, Ellison DH, Chade AR, Crowley SD, et al. Animal Models of Hypertension: A Scientific Statement From the American Heart Association. Hypertension. 2019; 73(6):e87-e120.
  36. Jama HA, Muralitharan RR, Xu C, O'Donnell JA, Bertagnolli M, Broughton BRS, et al. Rodent models of hypertension. Br J Pharmacol. 2022; 179(5):918-937.
  37. Queiroz MG, Prado AGK, Alves-Santos ÉT, Araújo JA, Damazo AS, Cambri LT. Influence of family history of hypertension on blood pressure and heart rate variability in young adults: a meta-analysis. Blood Press Monit. 2022; 27(4):259-271.
  38. Grassi G. The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey. Am J Hypertens. 2021; 34(12):1247-54.
  39. Hanna VS, Hafez EAA. Synopsis of arachidonic acid metabolism: A review. J Adv Res. 2018; 11:23-32.
  40. Norel X, Sugimoto Y, Ozen G, Abdelazeem H, Amgoud Y, Bouhadoun A, et al. International Union of Basic and Clinical Pharmacology. CIX. Differences and Similarities between Human and Rodent Prostaglandin E2 Receptors (EP1-4) and Prostacyclin Receptor (IP): Specific Roles in Pathophysiologic Conditions. Pharmacol Rev. 2020; 72(4):910-968.
  41. Hoorn EJ, Gritter M, Cuevas CA, Fenton RA. Regulation of the Renal NaCl Cotransporter and Its Role in Potassium Homeostasis. Physiol Rev. 2020; 100(1):321-356.
  42. Sequeira-Lopez MLS, Gomez RA. Renin Cells, the Kidney, and Hypertension. Circ Res. 2021; 128(7):887-907.
  43. Meurer M, Ebert K, Schweda F, Höcherl K. The renal vasodilatory effect of prostaglandins is ameliorated in isolated-perfused kidneys of endotoxemic mice. Pflugers Arch. 2018; 470(11):1691-1703.
  44. Avendaño MS, García-Redondo AB, Zalba G, González-Amor M, Aguado A, Martínez-Revelles S, et al. mPGES-1 (Microsomal Prostaglandin E Synthase-1) Mediates Vascular Dysfunction in Hypertension Through Oxidative Stress. Hypertension. 2018; 72(2):492-502.
  45. D'Agostino I, Tacconelli S, Bruno A, Contursi A, Mucci L, Hu X, et al. Low-dose Aspirin prevents hypertension and cardiac fibrosis when thromboxane A2 is unrestrained. Pharmacol Res. 2021; 170:105744.
  46. van Dorst DCH, Dobbin SJH, Neves KB, Herrmann J, Herrmann SM, Versmissen J, et al. Hypertension and Prohypertensive Antineoplastic Therapies in Cancer Patients. Circ Res. 2021; 128(7):1040-1061.
  47. Rahman MS, Hossain KS, Das S, Kundu S, Adegoke EO, Rahman MA, et al. Role of Insulin in Health and Disease: An Update. Int J Mol Sci. 2021; 22(12):6403.
  48. Dludla PV, Mabhida SE, Ziqubu K, Nkambule BB, Mazibuko-Mbeje SE, Hanser S, et al. Pancreatic β-cell dysfunction in type 2 diabetes: Implications of inflammation and oxidative stress. World J Diabetes. 2023; 14(3):130-146.
  49. Liu M, Weiss MA, Arunagiri A, Yong J, Rege N, Sun J, et al. Biosynthesis, structure, and folding of the insulin precursor protein. Diabetes Obes Metab. 2018; 20 Suppl 2(Suppl 2):28-50.
  50. Norris N, Yau B, Kebede MA. Isolation and Proteomics of the Insulin Secretory Granule. Metabolites. 2021; 11(5):288.
  51. Kawamori D. Exploring the molecular mechanisms underlying α- and β-cell dysfunction in diabetes. Diabetol Int. 2017; 8(3):248-256.
  52. Eizirik DL, Pasquali L, Cnop M. Pancreatic β-cells in type 1 and type 2 diabetes mellitus: different pathways to failure. Nat Rev Endocrinol. 2020; 16(7):349-362.
  53. Vilas-Boas EA, Almeida DC, Roma LP, Ortis F, Carpinelli AR. Lipotoxicity and β-Cell Failure in Type 2 Diabetes: Oxidative Stress Linked to NADPH Oxidase and ER Stress. Cells. 2021; 10(12):3328.
  54. Holman GD. Structure, function and regulation of mammalian glucose transporters of the SLC2 family. Pflugers Arch - Eur J Physiol. 2020; 472:1155-75.
  55. Arunagiri A, Haataja L, Cunningham CN, Shrestha N, Tsai B, Qi L, et al. Misfolded proinsulin in the endoplasmic reticulum during development of beta cell failure in diabetes. Ann N Y Acad Sci. 2018; 1418(1):5-19.
  56. Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018; 17(1):122.
  57. Limberg JK, Soares RN, Padilla J. Role of the Autonomic Nervous System in the Hemodynamic Response to Hyperinsulinemia-Implications for Obesity and Insulin Resistance. Curr Diab Rep. 2022; 22(4):169-175.
  58. Brosolo G, Da Porto A, Bulfone L, Vacca A, Bertin N, Scandolin L, Catena C, Sechi LA. Insulin Resistance and High Blood Pressure: Mechanistic Insight on the Role of the Kidney. Biomedicines. 2022; 10(10):2374.
  59. Libianto R, Batu D, MacIsaac RJ, Cooper ME, Ekinci EI. Pathophysiological Links Between Diabetes and Blood Pressure. Can J Cardiol. 2018; 34(5):585-594.
  60. Maruhashi T, Higashi Y. Pathophysiological Association between Diabetes Mellitus and Endothelial Dysfunction. Antioxidants (Basel). 2021; 10(8):1306.
  61. Konukoglu D, Uzun H. Endothelial Dysfunction and Hypertension. Adv Exp Med Biol. 2017; 956:511-40.
  62. Griendling KK, Camargo LL, Rios FJ, Alves-Lopes R, Montezano AC, Touyz RM. Oxidative Stress and Hypertension. Circ Res. 2021; 128(7):993-1020.
  63. Volpe CMO, Villar-Delfino PH, Dos Anjos PMF, Nogueira-Machado JA. Cellular death, reactive oxygen species (ROS) and diabetic complications. Cell Death Dis. 2018; 9(2):119.
  64. Guzik TJ, Touyz RM. Oxidative Stress, Inflammation, and Vascular Aging in Hypertension. Hypertension. 2017; 70(4):660-667.
  65. Charlton A, Garzarella J, Jandeleit-Dahm KAM, Jha JC. Oxidative Stress and Inflammation in Renal and Cardiovascular Complications of Diabetes. Biology (Basel). 2020; 10(1):18.
  66. Piché ME, Tchernof A, Després JP. Obesity Phenotypes, Diabetes, and Cardiovascular Diseases. Circ Res. 2020; 126(11):1477-1500.
  67. Janochova K, Haluzik M, Buzga M. Visceral fat and insulin resistance - what we know? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019; 163(1):19-27.
  68. Lavie CJ, Arena R, Alpert MA, Milani RV, Ventura HO. Management of cardiovascular diseases in patients with obesity. Nat Rev Cardiol. 2018; 15(1):45-56.
  69. Yen FS, Wei JC, Chiu LT, Hsu CC, Hwu CM. Diabetes, hypertension, and cardiovascular disease development. J Transl Med. 2022; 20(1):9.
  70. Kalantar-Zadeh K, Jafar TH, Nitsch D, Neuen BL, Perkovic V. Chronic kidney disease. Lancet. 2021; 398(10302):786-802.
  71. Yu SM, Bonventre JV. Acute Kidney Injury and Progression of Diabetic Kidney Disease. Adv Chronic Kidney Dis. 2018; 25(2):166-180.
  72. Verbrugge FH, Guazzi M, Testani JM, Borlaug BA. Altered Hemodynamics and End-Organ Damage in Heart Failure: Impact on the Lung and Kidney. Circulation. 2020; 142(10):998-1012.
  73. Locke JE, Reed RD, Massie A, MacLennan PA, Sawinski D, Kumar V, et al. Obesity increases the risk of end-stage renal disease among living kidney donors. Kidney Int. 2017; 91(3):699-703.
  74. Kropp M, Golubnitschaja O, Mazurakova A, Koklesova L, Sargheini N, Vo TKS, et al. Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications-risks and mitigation. EPMA J. 2023; 14(1):21-42.
  75. Tarr JM, Kaul K, Chopra M, Kohner EM, Chibber R. Pathophysiology of diabetic retinopathy. ISRN Ophthalmol. 2013; 343560.
  76. Sethi Y, Uniyal N, Vora V, Agarwal P, Murli H, Joshi A, et al. Hypertension the 'Missed Modifiable Risk Factor' for Diabetic Neuropathy: a Systematic Review. Curr Probl Cardiol. 2023; 48(4):101581.
  77. Yachmaneni A Jr, Jajoo S, Mahakalkar C, Kshirsagar S, Dhole S. A Comprehensive Review of the Vascular Consequences of Diabetes in the Lower Extremities: Current Approaches to Management and Evaluation of Clinical Outcomes. Cureus. 2023; 15(10):e47525.
  78. Sukumar S, Orkaby AR, Schwartz JB, Marcum Z, Januzzi JL, Vaduganathan M, et al. Polypharmacy in Older Heart Failure Patients: a Multidisciplinary Approach. Curr Heart Fail Rep. 2022; 19(5):290-302.
  79. Trento M, Fornengo P, Amione C, Salassa M, Barutta F, Gruden G, et al. Self-management education may improve blood pressure in people with type 2 diabetes. A randomized controlled clinical trial. Nutr Metab Cardiovasc Dis. 2020; 30(11):1973-1979.
  80. Umegaki H. Frailty, multimorbidity, and polypharmacy: Proposal of the new concept of the geriatric triangle. Geriatr Gerontol Int. 2025; 25(5):657-662.
  81. Morley JE, Abbatecola AM, Woo J. Management of Comorbidities in Older Persons With Type 2 Diabetes. J Am Med Dir Assoc. 2017; 18(8):639-645.
  82. Rivasi G, Ceolin L, Capacci M, Matteucci G, Testa GD, Ungar A. Risks associated with intensive blood pressure control in older patients. Kardiol Pol. 2023; 81(5):446-454.
  83. Park S. Ideal Target Blood Pressure in Hypertension. Korean Circ J. 2019; 49(11):1002-1009.
  84. Bogaerts JMK, von Ballmoos LM, Achterberg WP, Gussekloo J, Streit S, van der Ploeg MA, et al. Do we AGREE on the targets of antihypertensive drug treatment in older adults: a systematic review of guidelines on primary prevention of cardiovascular diseases. Age Ageing. 2022; 51(1):afab192.
  85. Qaseem A, Wilt TJ, Rich R, Humphrey LL, Frost J, Forciea MA, et al. Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2017; 166(6):430-437.
  86. Aschmann HE, Boyd CM, Robbins CW, Mularski RA, Chan WV, Sheehan OC, et al. Balance of benefits and harms of different blood pressure targets in people with multiple chronic conditions: a quantitative benefit-harm assessment. BMJ Open. 2019; 9(8):e028438.
  87. Joseph A, Wanono R, Flamant M, Vidal-Petiot E. Orthostatic hypotension: A review. Nephrol Ther. 2017; 13 Suppl 1:S55-S67.
  88. Fasil A, Biadgo B, Abebe M. Glycemic control and diabetes complications among diabetes mellitus patients attending at University of Gondar Hospital, Northwest Ethiopia. Diabetes Metab Syndr Obes. 2018; 12:75-83.
  89. Rodríguez-Gutiérrez R, Millan-Alanis JM, Barrera FJ, McCoy RG. Value of Patient-Centered Glycemic Control in Patients with Type 2 Diabetes. Curr Diab Rep. 2021; 21(12):63.
  90. Kim KJ, Choi J, Bae JH, Kim KJ, Yoo HJ, Seo JA, et al. Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study. Diabetes Metab J. 2021; 45(3):368-378.
  91. Sugimoto T, Noma H, Kuroda Y, Matsumoto N, Uchida K, Kishino Y, et al. Time trends (2012-2020) in glycated hemoglobin and adherence to the glycemic targets recommended for elderly patients by the Japan Diabetes Society/Japan Geriatrics Society Joint Committee among memory clinic patients with diabetes mellitus. J Diabetes Investig. 2022; 13(12):2038-2046.
  92. Kezerle L, Shalev L, Barski L. Treating the elderly diabetic patient: special considerations. Diabetes Metab Syndr Obes. 2014; 7:391-400.
  93. Hoogwerf BJ. Hypoglycemia in Older Patients. Clin Geriatr Med. 2020; 36(3):395-406.
  94. Verma M, Grover S, Tripathy JP, Singh T, Nagaraja SB, Kathirvel S, et al. Co-existing Non-communicable Diseases and Mental Illnesses Amongst the Elderly in Punjab, India. Eur Endocrinol. 2019; 15(2):106-112.
  95. Moke EG, Demaki WE, Daubry TME, Ataikiru OM, Agbonifo-Chijiokwu E, Ofulue OO, et al. Coexistence of hypertension with diabetes mellitus and its pharmacotherapy. Scientia Africana. 2023; 22(2):135-154.
  96. Kwakye AO, Oppong MB, Kretchy IA. Pharmacist interventions to improve medication adherence in patients with co-morbid hypertension and diabetes: a scoping review and bibliometric analysis. Int J Pharm Pract. 2025; 33(2):134-145.
  97. Foguet-Boreu Q, Violán C, López Jiménez T, Pons-Vigués M, Rodríguez-Blanco T, Valderas JM, et al. Pharmacological control of diabetes and hypertension comorbidity in the elderly: A study of "real world" data. Prim Care Diabetes. 2017; 11(4):348-359.
  98. Böhm M, Schumacher H, Teo KK, Lonn EM, Mahfoud F, Mann JFE, et al. Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials. Lancet. 2017; 389(10085):2226-2237.
  99. Mathur S, Zammitt NN, Frier BM. Optimal glycaemic control in elderly people with type 2 diabetes: what does the evidence say? Drug Saf. 2015; 38(1):17-32.
  100. Hoel RW, Giddings Connolly RM, Takahashi PY. Polypharmacy Management in Older Patients. Mayo Clin Proc. 2021; 96(1):242-256.
  101. Banerjee D, Winocour P, Chowdhury TA, De P, Wahba M, Montero R, et al. Management of hypertension and renin-angiotensin-aldosterone system blockade in adults with diabetic kidney disease: Association of British Clinical Diabetologists and the Renal Association UK guideline update 2021. BMC Nephrol. 2022; 23(1):9.
  102. Zhang P, Zhu L, Cai J, Lei F, Qin JJ, Xie J, et al. Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19. Circ Res. 2020; 126(12):1671-1681.
  103. Moke EG, Omogbai EKI, Osagie-Eweka SE, Uchendu AP, Obayuwana OM, Okoro-Akpandu E, et al. Antihypertensive and antihyperglycemic effects of combinations of losartan with metformin and/or glibenclamide in desoxycorticosterone acetate and streptozotocin-induced hypertensive diabetic rats. Lab Anim Res. 2023; 39(1):7.
  104. Jones KE, Hayden SL, Meyer HR, Sandoz JL, Arata WH, Dufrene K, et al. The Evolving Role of Calcium Channel Blockers in Hypertension Management: Pharmacological and Clinical Considerations. Curr Issues Mol Biol. 2024; 46(7):6315-6327.
  105. McNally RJ, Morselli F, Farukh B, Chowienczyk PJ, Faconti L. A review of the prescribing trend of thiazide-type and thiazide-like diuretics in hypertension: A UK perspective. Br J Clin Pharmacol. 2019; 85(12):2707-2713.
  106. Pathak A, Mrabeti S. β-Blockade for Patients with Hypertension, Ischemic Heart Disease or Heart Failure: Where are We Now? Vasc Health Risk Manag. 2021; 17:337-348.
  107. Grammatiki M, Sagar R, Ajjan RA. Metformin: Is it Still the First Line in Type 2 Diabetes Management Algorithm? Curr Pharm Des. 2021; 27(8):1061-1067.
  108. Moke EG, Omogbai EKI, Osagie-Eweka SDE, Uchendu AP, Omogbiya AI, Ben-Azu B, et al. Co-administration of metformin and/or glibenclamide with losartan reverse NG-nitro-l-arginine-methyl ester-streptozotocin-induced hypertensive diabetes and haemodynamic sequelae in rats. Microvasc Res. 2023; 147:104497.
  109. Islam N, Reynier P, Douros A, Yu OHY, Filion KB. Sulphonylureas versus metformin and the risk of ventricular arrhythmias among people with type 2 diabetes: A population-based cohort study. Diabetes Obes Metab. 2023; 25(6):1523-1533.
  110. Lundkvist P, Pereira MJ, Kamble PG, Katsogiannos P, Langkilde AM, Esterline R, et al. Glucagon Levels During Short-Term SGLT2 Inhibition Are Largely Regulated by Glucose Changes in Patients With Type 2 Diabetes. J Clin Endocrinol Metab. 2019; 104(1):193-201.
  111. Lazzaroni E, Ben Nasr M, Loretelli C, Pastore I, Plebani L, Lunati ME, et al. Anti-diabetic drugs and weight loss in patients with type 2 diabetes. Pharmacol Res. 2021; 171:105782.
  112. Forycka J, Hajdys J, Krzemińska J, Wilczopolski P, Wronka M, Młynarska E, et al. New Insights into the Use of Empagliflozin-A Comprehensive Review. Biomedicines. 2022; 10(12):3294.
  113. Benetos A, Petrovic M, Strandberg T. Hypertension Management in Older and Frail Older Patients. Circ Res. 2019; 124(7):1045-1060.
  114. Seiden LG, Connor GS. The importance of drug titration in the management of patients with epilepsy. Epilepsy Behav. 2022; 128:108517.
  115. Papotti B, Marchi C, Adorni MP, Potì F. Drug-drug interactions in polypharmacy patients: The impact of renal impairment. Curr Res Pharmacol Drug Discov. 2021; 2:100020.
  116. Mordarska K, Godziejewska-Zawada M. Diabetes in the elderly. Prz Menopauzalny. 2017; 16(2):38-43.
  117. Marcum ZA, Hanlon JT, Murray MD. Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials. Drugs Aging. 2017; 34(3):191-201.
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Published in Vol. 9 No. 1: African Journal of Tropical Medicine and Biomedical Research, July 2026

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Akponah E, Moke EG, Elijah OB, Ovili-Odili BZ, Ekakitie LI, Ben-Azu B, et al. Pharmacotherapy Of Hypertension And Diabetes Co-Morbidity In The Elderly: A Narrative Review. Afr. J. Trop. Med. Biomed. Res. [Internet]. 2026 Jul. 31 [cited 2026 Aug. 27];9(1):148–171. Available from: https://ajtmbr.org.ng/index.php/home/article/view/hypertension-diabetes-elderly
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