Over half of type 2 diabetics, particularly women, are likely to be hypertensive at age 50 using the recently recommended cutoff of 130/85 mm Hg. The cause is multifactorial and includes insulin resistance, which is closely related to obesity, itself a risk factor for hypertension. The first-line treatment is lifestyle modification (exercise, weight loss, and smoking withdrawal). This must almost always be aided by drugs, preferably a long-acting angiotensin-converting enzyme inhibitor on the grounds of hard end points (cardiovascular events), renoprotection, and quality of life (decreased impotence), often combined with a low-dose diuretic or a dihydropyridine calcium channel blocker. Proteinuria warrants even more stringent blood pressure control (125/75 mm Hg). Finally, aggressive use of statins may be beneficial even if initial cholesterol levels are only average...