Initial Hypertension Management in Diabetes

Initial Management of Hypertension in patients with Diabetes mellitus In patients with

diabetes, antihypertensive therapy should be initiated at BP ≥130/80 mmHg,

alongside lifestyle modification for all patients. If BP is ≥20/10 mmHg above target

(~≥150/90 mmHg), consider starting two agents. Albuminuria (UACR ≥30 mg/g) mandates

ACE inhibitor or ARB as first-line therapy. Other first-line options include

thiazide-like diuretics and dihydropyridine CCBs; if two drugs are required, ACEi/ARB + CCB or

ACEi/ARB + thiazide is recommended. Avoid combining ACEi + ARB. Comorbidities (CAD,

HF, CKD) should guide drug selection but do not change the core algorithm.