Kamishima K, et al. - In hypertensive patients with coronary artery disease (CAD) and type 2 diabetes mellitus, researchers analyzed the associations between blood pressure (BP) lowering therapy and cardiovascular events. Type 2 diabetes was diagnosed in 780 of a total of 2,049 CAD patients enrolled in the HIJ-CREATE study. The primary outcome occurred in 259 diabetic patients and in 293 non-diabetic patients during a median follow-up of 4.2 years. Even in a high-risk population, intensive BP reduction might not affect the clinical courses of patients. The intensive reduction of systolic BP to less than 120 mmHg did not correspond to an increased risk of major adverse cardiovascular events (MACEs). The connections between achieved BP and the incidence of MACEs did not follow a J-shaped curve. It is essential to establish an optimal management strategy for patients with hypertension with diabetes and CAD.