THE BEST APPROACH for the treatment of hypertension in diabetic patients is a subject of much debate. However, data from a variety of studies, including the Hypertension Optimal Treatment (HOT) study,1 Syst-Eur trial,2 and the Symbolic Hypertension in the Elderly Program (SHEP),3 show that the treatment of hypertension in diabetic patients lowers cardiovascular mortality and events to a greater extent than in the nondiabetic population. Moreover, results from the UK Prospective Diabetes Study (UKPDS) trial4 showed a 37% reduction in microvascular end points, with differences in systolic and diastolic blood pressure of only 10 mm Hg and 5 mm Hg, respectively, between the more tightly controlled and less tightly controlled groups. Therefore, much benefit is possible from aggressive treatment of hypertension in the diabetic population.
Peters AL, Hsueh W. Antihypertensive Agents in Diabetic PatientsGreat Benefits, Special Risks. Arch Intern Med. 1999;159(6):541–542. doi:10.1001/archinte.159.6.541