What should be the blood pressure target for diabetic patients?

To summarize the pros and cons of a lower-than-usual blood pressure goal (e.g., <130/80 mmHg) for diabetic patients.

Aside from general socioeconomic and preventive medicine principles that either support or reject potential benefits associated with a lower blood pressure goal, clinical trial data from the last millennium have been challenged by the results of the prospective, randomized, National Institutes of Health-sponsored Action to Control Cardiovascular Risk in Diabetes trial, which found no significant benefit for a systolic goal of less than 120 mmHg, compared with less than 140 mmHg. Updated meta-analyses of five clinical trials are presented that show a significant (P < 0.05) reduction in the risk of stroke or major cardiovascular events.

Although a major clinical trial has shown that it is possible to lower blood pressure to a very low goal in a large number of diabetic patients, it remains to be seen whether those who are preparing the Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure will agree with the American Diabetes Association and continue to recommend the less than 130/80 mmHg target for all diabetic patients.