Progress in hypertension and diabetes mellitus in 2009 is clearly illustrated by the findings of, and discussions provoked by, the ONTARGET study, by publication of the first clinical trials of aliskiren, and by the results of studies investigating strict glycemic control in diabetic patients. The results of the ONTARGET, TRANSCEND and ACCOMPLISH studies have kept alive active discussions about the maximum desirable blood pressure reduction and the best combination therapy. Furthermore, publication of the AVOID and ALLAY studies has proved a real novelty in the treatment of hypertension; they provided evidence for the safety and efficacy of a new family of drugs: the direct renin inhibitors. Also in 2009, a serious debate was provoked by the publication of several studies questioning strict glycemic control in diabetic patients. Finally, the year saw the publication of a scientific society consensus document that emphasized strict control of risk factors and minimization of the risk of hypoglycemia associated with intensive treatment in high-risk patients.