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Treatment ● Patients with a systolic blood pressure 130–139 mmHg or a diastolic blood pressure 80–89 mmHg may be given lifestyle therapy alone for a maximum of 3 months, and then if targets are not achieved, patients should be treated with the addition of pharmacological agents. (E) ● Patients with more severe hypertension (systolic blood pressure _140 mmHg or diastolic blood pressure _90 mmHg) at diagnosis or follow-up should receive pharmacologic therapy in addition to lifestyle therapy. (A) ● Lifestyle therapy for hypertension consists of weight loss if overweight, DASH-style dietary pattern including reducing sodium and increasing potassium intake, moderation of alcohol intake, and increased physical activity. (B) ● Pharmacologic therapy for patients with diabetes and hypertension should be paired with a regimen that includes either an ACE inhibitor or an angiotensin II receptor blocker (ARB). If one class is not tolerated, the other should be substituted. If needed to achieve blood pressure targets, a thiazide diuretic should be added to those with an estimated glomerular filtration rate (GFR) (see below) _30 ml _ min/1.73 m2 and a loop diuretic for those with an estimated GFR _30 ml _ min/1.73 m2. (C) ● Multiple drug therapy (two or more agents at maximal doses) is generally required to achieve blood pressure targets. (B) ● If ACE inhibitors, ARBs, or diuretics are used, kidney function and serum potassium levels should be closely monitored. (E) ● In pregnant patients with diabetes and chronic hypertension, blood pressure target goals of 110–129/65–79 mmHg are suggested in the interest of longterm maternal health and minimizing impaired fetal growth. ACE inhibitors and ARBs are contraindicated during pregnancy. (E) Hypertension is a common comorbidity of diabetes that affects the majority of patients, with prevalence depending on type of diabetes, age, obesity, and ethnicity. Hypertension is a major risk factor for both CVD and microvascular complications. In