Statement on hypertension in diabetes.

Hypertension and diabetes mellitus are commonly associated. Hypertension contributes substantially to morbidity and mortality in the diabetic population. This report was prepared as a practical guide for the management of hypertension in diabetic patients. Although treatment of hypertension in most diabetic patients does not differ from that in nondiabetic patients, this report outlines some special considerations relevant to the presence of both diseases. For both hypertension and diabetes, basic nonpharmacologic therapy consists of dietary alterations, exercise, weight management, smoking cessation, and restricted alcohol intake. These measures should be instituted as initial therapy or concomitant with pharmacologic measures. The stepped-care approach to drug treatment in essential hypertension serves as a guide to therapy. Flexibility in the use of antihypertensive drugs is suggested, and selected practical issues in drug treatment are reviewed.