Feature Article

Diabetes and hypertension – double trouble

Pat Phillips, Philip Y Popplewell, Lindon Wing



About 70% of Australians with type 2 diabetes also have hypertension, which further increases their already raised coronary risk. Patient outcomes are optimised by a step approach to controlling blood pressure while also managing glycaemia.

Key Points

  • Approximately 70% of Australians with type 2 diabetes have the ‘double trouble’ of diabetes and hypertension. In 75% of these patients, hypertension is untreated or uncontrolled.
  • Type 2 diabetes is associated with the same coronary risk as having had a myocardial infarct as well as increased risks of renal and eye damage.
  • Studies have shown decreasing cardiovascular risk with decreasing blood pressure and that certain hypotensive agents have advantages in particular situations.
  • Treating to target (under 130/85 mmHg) and a step approach optimises patient outcomes.
  • Diabetes management is now directed to the ABCss of diabetes care: control of HbA1c, Blood pressure and Cholesterol, quitting Smoking and using Salicylates.