[Therapeutic targets in arterial hypertension and diabetes mellitus. Can medical prevention be harmful?].

Arterial hypertension contributes considerably to the increased cardiorenal risk of patients with diabetes mellitus type 2. Therefore guideline-writing authorities recommend starting antihypertensive treatment generously, with the aim of reducing blood pressure to levels to < 130/80 mmHg. Nevertheless, results of several recent studies have challenged the currently prevailing paradigm "the lower the better" in hypertension management. A similar paradigm also seems to hold true for the management of blood glucose in these patients. Detailed analyses have shown an increased risk of coronary events by targeting both lower blood pressure and blood glucose levels, especially in those with established cardiovascular disease and especially coronary artery disease--thus, the concept of "the lower the better" should be reconsidered in this group of patients.