If you are one of the 11 million Americans who have both high blood pressure and diabetes, you should know about new treatment recommendations.

Experts agree that the target blood pressure for people with both conditions should be 130/80. Now there are suggestions that the pressure should be brought down to 125/75 to get the maximum benefit in terms of preventing kidney disease, which is a complication of both conditions.

Intensive BP control usually requires the use of more than one blood pressure-lowering medication. First of all, people with diabetes and high blood pressure should be taking an ACE inhibitor, since those agents have been shown to prevent or delay kidney disease as well as lower blood pressure. But you may also need additional medications. That's because many of the body's systems interact to produce increased blood pressure. Using two or more agents may improve response, because they are interrupting more than one of the body's physiologic pathways.

Research has shown that 29% of people with diabetes needed three or more medications to reduce their BP to 144/82. Other trials have identified a range of 2.8 to 4.2 different antihypertensive agents to achieve the desired goal.

Ask your doctor whether you should be taking additional medications to control your BP, particularly if you are not meeting your goal.

Related information: Diabetes channel | Basic Facts - Disease risks

Source:  Bakris, GL. A practical approach to achieving recommended blood pressure goals in diabetic patients. Archives of Internal Medicine, Dec. 10/24, 2001;161:2661-2667.