Comparison of Antihypertensive Therapy Outcomes in Diabetic Adults with Resistant Hypertension

Suleiman Mohammad^1,2*, Asokan Vasudevan^3,4, Hanan Jadallah⁵

¹*Electronic Marketing and social media, Economic and Administrative Sciences Zarqa University, Jordan. ²*Research follower, INTI International University, 71800 Negeri Sembilan, Malaysia. dr_sliman@yahoo.com, 0000-0001-6156-9063 ³Faculty of Business and Communications, INTI International University, 71800 Negeri Sembilan, Malaysia. ⁴Shinawatra University, 99 Moo 10, Bangtoey, Samkhok, Pathum Thani 12160 Thailand asokan.vasudevan@newinti.edu.my ⁵Electronic Marketing and social media, Economic and Administrative Sciences Zarqa University, Jordan. Hananjadallah1987@gmail.com, 0009-0005-7138-1167 Corresponding Author: Suleiman Mohammad

Received: 14^th Aug, 2025; Revised: 15^th Sep 2025; Accepted: 15^th Nov, 2025; Available Online: 30^th Nov, 2025

ABSTRACT

This paper is a critical analysis of the results of multi-drug antihypertensive treatment on diabetic resistant hypertension patients in terms of patterns of blood pressure and renal, cardiac remodelling, nocturnal variability and clusters of adverse events. Clinical trial and meta-analysis synthesis of secondary data had shown that angiotensin-converting enzyme inhibitor (ACEI)- or angiotensin receptor blocker (ARB)-based regimens, especially when used with calcium channel blockers (CCBs), produced the most consistent systolic and diastolic blood pressure reduction, and left-ventricular mass regression, as well as albuminuria. Mineralocorticoid receptor antagonists (MRAs) were found to offer an additional benefit in the restoration of nocturnal dipping and a decrease in variability but hyperkalemia and renal insufficiency required close follow-ups. Beta-blocker and diuretic-prominent regimens proved to have lower effectiveness and concentrated adverse metabolic events, which points to their lower applicability in diabetic groups. High-intensity titration was associated with better hemodynamic control and higher risks of electrolyte imbalances, orthostatic hypotension and non-adherence. In general, the results represent the necessity to apply an individualized treatment with the emphasis on RAAS inhibition and the use of adjunctive MRAs in combination with a balanced approach to efficacy and safety that integrated monitoring strategies can provide. The paper finds that the management of resistant hypertension in diabetic adults should be more than blood pressure reduction to include renal preservation, structural cardiac regression, stabilizing circadian rhythms, and preventing adverse events to ensure a long-term sustainable outcome..

Keywords: Resistant hypertension, Diabetic adults, Blood pressure, Renal function, Albuminuria, Mineralocorticoid receptor antagonists, ACEI or ARB, Calcium-channel blockers, Nocturnal pressure, Hyperkalemia

How to cite this article: Mohammad S, Vasudevan A, Jadallah H.; Comparison of antihypertensive therapy outcomes in diabetic adults with resistant hypertension. International Journal of Drug Delivery Technologies. 2025;15(4): 1826-1832, DOI: 10.25258/ijddt.15.4.35