In middle aged populations, the United Kingdom Prospective Diabetes Study has shown that tightly controlling blood pressure in diabetic people leads to a 24% reduction in diabetes related endpoints, 32% reduction in diabetes-related deaths and a 44% reduction in strokes. Benefits that are only sustained whilst good blood pressure control is maintained. Trials investigating hypertension and diabetes in dedicated older populations are limited. Subsequent treatment guidelines are based mainly on data extracted from younger populations. In older people polypharmacy, adverse drug reactions and postural hypotension are common and potential benefits of aggressive blood pressure treatment in relation to diabetic outcomes must be carefully considered.