This article reviews the clinical and vascular mechanisms linking diabetes and hypertension, which are common comorbidities. Hypertension is twice as prevalent in patients with diabetes compared to those without, and both conditions share similar risk factors such as endothelial dysfunction, vascular inflammation, arterial remodeling, atherosclerosis, dyslipidemia, and obesity. The major cause of morbidity and mortality in diabetes is cardiovascular disease, which is exacerbated by hypertension. Common mechanisms contributing to the close relationship between diabetes and hypertension include upregulation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, and immune system activation. The article discusses the pathophysiological features of vascular complications associated with these conditions, focusing on advanced glycation end products, oxidative stress, inflammation, the immune system, and microRNAs. It also highlights current therapies targeting diabetes and cardiovascular complications, including new agents with potential vasoprotective effects in diabetes.This article reviews the clinical and vascular mechanisms linking diabetes and hypertension, which are common comorbidities. Hypertension is twice as prevalent in patients with diabetes compared to those without, and both conditions share similar risk factors such as endothelial dysfunction, vascular inflammation, arterial remodeling, atherosclerosis, dyslipidemia, and obesity. The major cause of morbidity and mortality in diabetes is cardiovascular disease, which is exacerbated by hypertension. Common mechanisms contributing to the close relationship between diabetes and hypertension include upregulation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, and immune system activation. The article discusses the pathophysiological features of vascular complications associated with these conditions, focusing on advanced glycation end products, oxidative stress, inflammation, the immune system, and microRNAs. It also highlights current therapies targeting diabetes and cardiovascular complications, including new agents with potential vasoprotective effects in diabetes.