Higher blood pressure levels in patients with diabetes are associated with faster renal function decline in kidney disease. In addition, all vascular complications of diabetes are exacerbated by hypertension. Therefore, blood pressure should be treated aggressively in individuals with diabetes. Sodium restriction, weight loss, smoking cessation, proper diet, and exercise remain cornerstones of therapy.
Long term clinical trials have demonstrated the beneficial impact of lower blood pressure targets in patients with diabetes as compared to those without diabetes. Both the HOT (Hypertension Optimal Treatment) study and United Kingdom Prospective Diabetes Study or UKPDS study demonstrated that diabetics have improved outcomes with lower blood pressure goals. Because of these studies (and others), current national guidelines recommend target blood pressure in patients with diabetes to be <130/80 mm Hg. Similarly, blood pressure goals in patients with CKD is <130/80 mm Hg. In most studies of patients with CKD, multiple agents were required in most patients to achieve target blood pressure control.
What is the range of your blood pressure? When was the last time you checked your blood pressure?