ABSTRACT
Defining ‘hypertension’ in people with diabetes Diabetes and hypertension are both common conditions in Western societies. They frequently co-exist, more often than can be accounted for by chance. It was recognized over 60 years ago that hypertension is more common in people with diabetes.1 Subsequently it has often been stated that hypertension is at least twice as common in diabetic subjects when compared with the non-diabetic population, although the prevalence is clearly dependent on the definition of hypertension.2
Hypertension can be defined as the level of blood pressure (BP) at which cardiovascular risk is measurably increased for the population and/or the level of blood pressure at which its treatment has been shown to significantly reduce cardiovascular morbidity and mortality in prospective randomized clinical trials. This definition is not without problems when endeavouring to define hypertension for people with diabetes mellitus. Firstly, at any level of blood pressure, people with diabetes are at higher cardiovascular risk than those without diabetes. Thus, if the definition of hypertension were to be based on an absolute level of cardiovascular risk, the blood pressure level demarcating ‘hypertension’ for the diabetic population would be substantially lower than that for the non-diabetic population. This is graphically illustrated by reference to the work
