Blood pressure (BP) control in people with diabetes is more important and has more impact than glycemic control. About 80% of people with type 2 diabetes have hypertension, and over 50% have a BP above target. But what should the target be? The ACCORD trial looked at people with diabetes who had an increased cardiovascular risk, and concluded that a BP target of < 120 mm Hg was associated with more side effects and no benefits compared to a BP < 140 mm Hg. More recently the SPRINT trial, which also included people at increased cardiovascular risk but EXCLUDED people with diabetes, showed a benefit for BP < 120 mm Hg. This study released today in the American Journal of Medicine offers a nice meta-analysis of 17 large-scale trials, and concluded that a BP < 130 mm Hg offered the best balance of benefit and safety.
I think that < 130 mm Hg is a good overall goal for people with diabetes, with a caveat against over-treatment. The first anti-hypertensive agent brings the most benefit. Adding a third or fourth agent can increase side effects, costs and inconvenience while providing minimal additional benefit. Remember that exercise and relaxation therapies can also help.
See abstract here