Hypertension is a common diabetes
comorbidity that affects the majority
of patients, with the prevalence depending
on type of diabetes, age, obesity,
and ethnicity. Hypertension is a
major risk factor for both CVD and microvascular
complications. In type 1 diabetes,
hypertension is often the result
of underlying nephropathy, while in
type 2 diabetes it usually coexists with
other cardiometabolic risk factors.
Screening and Diagnosis
Blood pressure measurement should be
done by a trained individual and follow
the guidelines established for the general
population: measurement in the
seated position, with feet on the floor
and arm supported at heart level, after 5
min of rest. Cuff size should be appropriate
for the upper arm circumference.
Elevated values should be confirmed
on a separate day.
Home blood pressure self-monitoring
and 24-h ambulatory blood pressure
monitoring may provide evidence of
white coat hypertension, masked hypertension,
or other discrepancies between
office and “true” blood pressure. Studies
in individuals without diabetes found
that home measurements may better
correlate with CVD risk than office
measurements (4,5). However, most of
the evidence of benefits of hypertension
treatment in people with diabetes is
based on office measurements.