Hypertension in diabetes is the most widespread, substantial and treatable cardiovascular risk factors of importance in clinical practice. It is an increasingly important medical and public health issue. The prevalence of hypertension increases with advancing age to the point where more than half of people aged 60 to 69 years old and approximately three-fourths of those aged 70 years and older are affected. There is an intimate relationship between diabetes mellitus and hypertension. It was estimated that if diabetic patients live long enough, approximately 75% would develop hypertension. Both diabetes and high blood pressure tend to share many predisposing factors. High fat diets rich in salt and processed sugars put stress on both enzyme production and the cardiovascular systems. Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pressure significantly reduces the risk of macro vascular and micro vascular complications. Based on the weight of all evidence, angiotensin converting enzyme inhibitors or angiotensin receptor blockers is preferred first-line agents for treating patients with hypertension and diabetes. The need for combination therapy should be anticipated, and thiazide-type diuretics should be the second agent added. Based on scientific evidence, β-blockers and calcium channel blockers are useful evidence-based agents in this population, but consider add-on therapies to the aforementioned agents.
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