Treatment of coexisting diabetes and hypertension

The rapidly growing number of patients with coexisting diabetes and hypertension must be intensively treated to protect them from their very high risk for premature cardiovascular morbidity and mortality. After careful ascertainment of their out-of-the-office blood pressure, and testing for postural hypotension, therapy should consist of both lifestyle modifications and antihypertensive drugs. Usually, two or more such drugs are needed to bring blood pressure below the 130/85 mm Hg level. In addition, control of hyperglycemia and dyslipidemia is usually required. Despite the costs and difficulties of achieving adequate control of these diseases, such patients can be protected from the debilities of diabetes and hypertension.