In adults with DM and hypertension, all first- line classes of antihypertensive agents (ie, diuretics, ACE inhibitors, ARBs, and CCBs) are useful and effective.S9.6-1,S9.6-9,S9.6-10 IIb B-NR 3. In adults with DM and hypertension, ACE inhibitors or ARBs may be considered in the presence of albuminuria.S9.6-11,S9.6-12 SR indicates systematic review. Synopsis ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults for the complete system- atic evidence review for additional data and analyses.S9.6-13 The prevalence of hypertension among adults with DM is approxi- mately 80%, and hypertension is at least twice as common in persons with type 2 DM than in age-matched individuals with- The coexistence of hypertension and DM markedly increases the risk of developing CVD damage, result- ing in a higher incidence of CHD, HF, PAD, stroke, and CVD and may increase risk of microvascular disease, such as nephropathy or retinopathy.S9.6-16,S9.6-18 There is limited quality evidence to determine a precise BP target in adults with DM. No RCTs have explicitly 1) docu- mented whether treatment to an SBP goal <140 mm Hg versus a higher goal improves clinical outcomes in adults with hyper- tension and DM or 2) directly evaluated clinical outcomes associated with SBP <130 mm Hg.S9.6-2 However, 2 high-qual- ity systematic reviews of RCTs support an SBP target of <140 There is little or no available RCT evidence supporting a specific DBP threshold for initiation of pharmacological ther- apy. Several RCTs, including the HOT (Hypertension Optimal Treatment) trial, UKPDS (United Kingdom Prospective Diabetes Study), and ABCD (Appropriate Blood Pressure Control in Diabetes) trial,S9.6-19 S9.6-22 are often cited to support a lower DBP target (eg, 85 or 80 mm Hg) for adults with hypertension and DM. 