Hypertension in Adults With Type 2 Diabetes: A Review of Blood Pressure Measurement Methods, Targets and Therapy.

Hypertension occurs in more than two-thirds of patients with type 2 diabetes. In a retrospective analysis of a Framingham cohort, high blood pressure was associated with a 72% increase in the risk for all-cause death and a 57% increment in the risk for any cardiovascular disease event, making hypertension the strongest driver of cardiovascular outcomes in individuals with diabetes. One of the key aspects of hypertension management is the correct measurement of blood pressure; various types of monitoring in both clinic and ambulatory settings are reviewed here. Their benefits and challenges are presented along with the resources available to support clinicians and patients in better understanding and using the monitors. Specific phenotypes, such as white-coat hypertension and masked hypertension, are also addressed. This review outlines major trials that set systolic and diastolic blood pressure thresholds for patients with diabetes and hypertension. Optimal antihypertensive therapies are described in studies supporting these recommendations.