Invited review
Diabetes and hypertension

Hypertension in diabetes is a prevalent risk factor with serious consequences, not only for the development of macrovascular endpoints in patients with both type 1 and type 2 diabetes, but also for microvascular endpoints. Based on modern therapies, often used in synergistic combinations, it is possible to reverse this development of increased risk. Recent randomised controlled trials have shown that tight blood pressure control is associated with improved prognosis, for example in patients with type 2 diabetes recruited for the blood pressure arm of the ADVANCE trial. It is still, however, not determined where the goal for blood pressure control should be based on evidence in these patients. In the still ongoing blood pressure arm of the ACCORD trial the hypothesis is currently being tested whether lowering the systolic blood pressure below 120 mm Hg might confer extra benefits as compared to the usual control (less than 140 mm Hg). Data are awaited in 2010.