Table 2 BP goals in diabetics according to major guidelines

Year published

2011

2013

2014

2014

2016

2016

2012

Blood pressure (mmHg)

Not addressed

<140/85

<140/90

<140/90

<140/90

<130/80

<130/80

Special considerations

Begin treatment if BP > 140/90 mmHg

Systolic BP < 130 mmHg and diastolic BP < 80 may be appropriate for certain individuals with diabetes, such as younger patients, those with albuminuria, and/or those with hypertension and one or more additional atherosclerotic CV disease risk factors, if they can be achieved without undue treatment burden.

<140/90 mmHg in patients 70-80 years old <150/90 mmHg in patients over 80 years old

Recommended initial treatment

ACE inhibitor plus either a diuretic or a CCB

All classes of antihypertensive agents are recommended. RAAS blockers may be preferred, especially in the presence of proteinuria or microalbuminua

ARB or ACE inhibitor. In black patients, it is acceptable to start with a CCB or a thiazide.

Thiazide-type diuretic, CCB, ACE inhibitor or ARB

ACE inhibitor, ARB

ACE inhibitor, ARB in patients with CV or kidney disease, including microalbuminuria, or with CV risk factors

In patients without albuminuria, Thiazide-type diuretic, CCB, ACE inhibitor or ARB