Treatment of hypertension in patients with diabetes.

Approximately 3 million Americans have the dual diagnosis of hypertension and diabetes. Both conditions are associated with and are risk factors for cardiovascular events, nephropathy, and retinopathy. When these conditions coexist, the prevalence, progression, and severity of these adverse outcomes are dramatically enhanced. For these reasons, hypertension should be treated aggressively and early in the diabetic patient to curtail the morbidity and mortality associated with these disease states. To this end, a number of consensus statements have been formulated and promulgated in an effort to increase the awareness of this condition and to provide guidelines by which optimal care may be afforded to patients. In addition, specific patient and drug-related factors and conditions should be considered so patients can be committed to the optimal therapeutic plan. The outcome to attain optimal blood pressure should be mirrored by efforts to obtain glycemic and lipidemic control. By the implementation and optimization of effective therapeutic measures, which have the least amount of impact on the patient's concomitant disease states and body chemistry, positive differences in outcomes may be realized in this population.