Recommendations for the Treatment of Hypertension in Patients with DM: Critical Evaluation Based on Clinical Trials

Hypertension (blood pressure (BP) >140/90 mmHg) is a common comorbidity of type 2 DM (DM) and a major risk factor for macro- and microvascular complications. To review the effectiveness of different antihypertensive drugs in reducing BP, and diabetic complications in patients with DM, we analysed clinical trials, reviews and reports, published in Cochrane Library and PubMed from 1991 to 2004. Evidences suggest that optimal control of hypertension complications is obtained in diabetic patients when BP values are <130/80 mmHg. Different drug classes result useful to obtain this target BP, but their effects on different metabolic and non-metabolic aspects have to be taken in account and a flexible approach according to individual response to different regimens is essential.