The role of intensive blood pressure control in diabetes mellitus

Arterial hypertension (AH) is one of the most common comorbidities in patients with diabetes mellitus (DM), significantly increasing the risk of adverse outcomes and cardiovascular complications. The coexistence of these conditions is driven by shared pathophysiological mechanisms of metabolic disorders, as well as hereditary and acquired factors. Frequent coexistence of AH and DM requires certain principles of patient management and control. Blood pressure (BP) control, along with control of glycemia and lipid profile parameters, is one of the most important components of complex therapy of DM and its complications. The question of at what BP values it is necessary to initiate therapy and what should be the target BP values in patients with diabetes has been controversial for many years. Another issue requiring attention is the management of “prehypertension” or high normal BP in patients with DM. In this article, we will review the main benefits and risks of intensive BP control in patients with diabetes, as well as strategies for managing patients with prehypertension according to current clinical guidelines and the latest research data.