Diabetes with hypertension in China: current status of epidemiology and management

Diabetes is often accompanied by hypertension, which significantly increases the risk of cardiocerebrovascular and kidney diseases. Data from studies in China show that the detection rate of hypertension in patients with diabetes is about 60%, whereas the literature reports this rate to be ranging from 24.3% to 70.3%. The goal of blood pressure measurement among patients with diabetes is controversial in different guidelines. Based on data from China, a target systolic blood pressure of <130 mmHg is recommended. However, the control rate of hypertension is low in patients with diabetes. Most of the guidelines recommend angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists as the first-line antihypertensive drugs for patients with diabetes. Metformin, GLP-1 receptor agonists, SGLT-2 inhibitors, etc. have a synergistic antihypertensive effect. Lifestyle interventions, especially salt restriction, have a dominant effect on blood pressure control; however, there is a lack of relevant clinical research. Metabolic surgery can improve diabetes in patients with refractory hypertension. Additional clinical studies and evidence-based medicine are warranted to develop a Chinese guideline for subjects with diabetes mellitus with hypertension.