From 649 identified studies, the authors identified 9 relevant trials, which provided data Overall, inten- sive control of glucose compared with usual care had no effect however, in a stratified analyses, a beneficial effect was seen in patients with diabetes mellitus and a BMI >30 kg/m2 (RR, 0.86; 95% CI, 0.75 0.99; P=0.041). Diabetes Mellitus and Hypertension More aggressive lowering of BP in patients with diabetes mel- litus and hypertension reduces stroke incidence.300 In addition to comparing the effects of more intensive glycemic control and standard care on the complications of type 2 diabetes mellitus, the UKPDS found that tight BP control (mean BP, 144/82 mmHg) resulted in a 44% reduction (95% CI, 11 65; P=0.013) in the risk of stroke compared with more liberal control (mean BP, 154/87 mmHg).301 There was also a nonsta- reduction with antihypertensive treatment in subjects with dia- betes mellitus in SHEP.302 In UKPDS, 884 patients with type 2 diabetes mellitus who attended annual UKPDS clinics for 5 years after study completion were evaluated.303 Differences in BP between the 2 groups, standard of care and more aggres- sive BP lowering, disappeared within 2 years. There was a nonsignificant trend toward reduction in stroke with more intensive BP control (RR, 0.77; 95% CI, 0.55 1.07; P=0.12). Continued efforts to maintain BP targets might have led to maintenance of the benefit. The Heart Outcomes Prevention Evaluation (HOPE) study compared the addition of an ACEI to the current medical regi- men in high-risk patients. 