Diabetes and hypertension: too many guidelines, not enough data

The early diagnosis, appropriate management, and pharmacological treatment of hypertension in those with diabetes mellitus are key in preventing and reducing the significant risk of cardiovascular disease-related morbidity and mortality in this patient population. Despite the universal recognition of the importance of hypertension management in those with diabetes mellitus, there still remains controversy on the appropriate blood pressure at which to initiate pharmacologic therapy and, once initiated, what blood pressure goal to achieve. This paper will review current blood pressure recommendations published in recent major guidelines as well as examine evidence-based medicine used to form the basis of these guidelines for the treatment of hypertension in patients with diabetes mellitus. In addition, we will summarize relevant major clinical studies, which may have a significant impact on future guidelines, published in the interval time since the release of previous major guidelines.