The presence of hypertension (HT) causes a 7.2-fold increase in mortality in diabetic patients. The macrovascular complications, which are well recognized in patients with long-standing diabetes or HT, include stable coronary artery disease, myocardial infarction, stroke, congestive heart failure, and peripheral vascular diseases. Although microvascular complications (retinopathy, nephropathy, and neuropathy) are conventionally linked to hyperglycemia, studies have shown that HT constitutes an important risk factor, especially for nephropathy. This chapter covers the diabetic patient with hypertension, United Kingdom prospective diabetes study (UKPDS) group, captopril prevention project trial, heart outcomes prevention evaluation trial, other factors contributing to increased cardiovascular disease in diabetic patients, diabetic cardiomyopathy, microalbuminuria and cardiovascular disease in diabetes, and therapeutic implications.