THE BEST APPROACH for the treatment of hypertension in diabetic patients is a subject of much debate. However, data from a variety of studies, including the Hypertension Optimal Treatment (HOT) study,1 Syst-Eur trial,2 and the Symbolic Hypertension in the Elderly Program (SHEP),3 show that the treatment of hypertension in diabetic patients lowers cardiovascular mortality and events to a greater extent than in the nondiabetic population. Moreover, results from the UK Prospective Diabetes Study (UKPDS) trial4 showed a 37% reduction in microvascular end points, with differences in systolic and diastolic blood pressure of only 10 mm Hg and 5 mm Hg, respectively, between the more tightly controlled and less tightly controlled groups. Therefore, much benefit is possible from aggressive treatment of hypertension in the diabetic population.
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