Diabetes and hypertension are common comorbidities, with hypertension being twice as frequent in patients with diabetes. Both conditions are closely linked due to shared risk factors such as endothelial dysfunction, vascular inflammation, and oxidative stress. Cardiovascular disease is the leading cause of morbidity and mortality in diabetes, exacerbated by hypertension. The article discusses the pathophysiological features of vascular complications associated with diabetes and hypertension, highlighting mechanisms such as the renin-angiotensin-aldosterone system, oxidative stress, and inflammation. It also explores the role of advanced glycation end products, microRNAs, and the immune system in these conditions. Current therapies targeting diabetes and cardiovascular complications are reviewed, with a focus on new agents with vasoprotective potential. The article emphasizes the importance of managing comorbidities, particularly hypertension, to reduce vascular complications in diabetes. It also discusses the impact of oxidative stress, inflammation, and fibrosis on vascular disease, and highlights emerging therapeutic approaches targeting these mechanisms. The conclusion emphasizes the need for strategies to promote vascular health in diabetes patients.Diabetes and hypertension are common comorbidities, with hypertension being twice as frequent in patients with diabetes. Both conditions are closely linked due to shared risk factors such as endothelial dysfunction, vascular inflammation, and oxidative stress. Cardiovascular disease is the leading cause of morbidity and mortality in diabetes, exacerbated by hypertension. The article discusses the pathophysiological features of vascular complications associated with diabetes and hypertension, highlighting mechanisms such as the renin-angiotensin-aldosterone system, oxidative stress, and inflammation. It also explores the role of advanced glycation end products, microRNAs, and the immune system in these conditions. Current therapies targeting diabetes and cardiovascular complications are reviewed, with a focus on new agents with vasoprotective potential. The article emphasizes the importance of managing comorbidities, particularly hypertension, to reduce vascular complications in diabetes. It also discusses the impact of oxidative stress, inflammation, and fibrosis on vascular disease, and highlights emerging therapeutic approaches targeting these mechanisms. The conclusion emphasizes the need for strategies to promote vascular health in diabetes patients.