Published in Family Physician 2011.6.27, Vol. 1324, No. 4. In recent years, it has been increasingly recognized that diabetes and hypertension, as major chronic diseases that threaten human health, often follow each other. A survey in Hong Kong showed that 46.4% of diabetic patients also had hypertension and 23.2% of hypertensive patients had coexisting diabetes. Su Guanhua, Department of Cardiovascular Medicine, Wuhan Union Hospital Hypertension and diabetes: a difficult brother and sister Hypertension and diabetes have many common risk factors and enjoy a common pathogenic soil, including age (increase), smoking, genetics, obesity, poor lifestyle, insulin resistance, etc., so they often coexist, like a pair of “difficult brothers and sisters The two are often found together, like a pair of “difficult brothers”. Diabetic patients due to disorders of sugar metabolism, prompting certain components of the blood and tissue glycation, will accelerate and aggravate the formation of atherosclerosis; hypertensive patients due to fat accumulation, blood vessel wall thickening and hardening, loss of elasticity, etc., will lead to local tissue ischemia and hypoxia, will also contribute to the aggravation of diabetes, forming a vicious circle. Both can damage blood vessels, heart, brain and kidneys, significantly increasing the risk of coronary heart disease, stroke, chronic renal failure and other diseases. Diabetes and hypertension are like two “bitter gourds” on the same vine, which follow each other and influence each other to aggravate the development of the disease. The treatment goal of hypertension combined with diabetes is to prevent and control hypertension, and domestic and international guidelines for the prevention and treatment of hypertension point out that even if you have Grade 1 hypertension, you are at high risk for cardiovascular disease if you have diabetes. Strict control of blood pressure and blood glucose can significantly reduce cardiac, cerebral, renal and microvascular events and mortality in hypertension combined with diabetes mellitus. The goal of blood pressure control in patients with hypertension combined with diabetes mellitus is to reduce blood pressure to below 130/80 mm Hg in patients without serious complications; those with combined microvascular lesions should consult a specialist to achieve individualized antihypertensive treatment. The target of blood glucose control in patients with hypertension combined with diabetes: in general, fasting blood glucose should be less than 6 mmol/L; postprandial blood glucose should be less than 8 mmol/L; glycated hemoglobin (HbA1c) should not exceed 6.5%. Currently, domestic and international guidelines for the treatment of hypertension combined with diabetes mellitus recommend angiotensin-converting enzyme inhibitors (ACEI) such as perindopril, fosinopril, benazepril, midazepril, etc. and angiotensin II receptor antagonists (ARB) such as irbesartan, olmesartan, valsartan, crosartan, candesartan, etc. as the first choice of antihypertensive drugs for hypertensive patients with diabetes mellitus. Both ACEI and ARBs are effective in lowering blood pressure while also playing a beneficial role in abnormal glucose metabolism. ARBs are recommended as the first choice for the treatment of type 2 diabetes mellitus because of the stronger evidence for antihypertensive therapy and the management of related complications. Recent studies have shown that calcium antagonists combined with ACEIs or ARBs are the superior antihypertensive drug combinations for patients with diabetes combined with hypertension. Long-acting calcium antagonists such as amlodipine, lercanidipine, and felodipine extended-release tablets are safe and effective in lowering blood pressure without adverse effects on glucose and lipid metabolism, and also have the effect of reducing the occurrence of stroke and kidney damage. China has more than 200 million hypertensive patients, that is, at least 2 out of every 10 adults suffer from hypertension; the total number of people with diabetes is as high as 92.4 million, and a total of 148 million people are in pre-diabetes. In the face of such a large group and the grim reality, we can neither isolate hypertension or diabetes, nor isolate the prevention and treatment of hypertension or diabetes, but should be three-dimensional prevention and treatment, early prevention and treatment, comprehensive prevention and treatment.