OBJECTIVES: Healthcare Effectiveness Data and Information Set (HEDIS) defines controlled hypertension as systolic/diastolic BP (SBP/DBP) <130/80 mm Hg for patients with essential hypertension and diabetes. We estimated the percentage of diabetes patients with uncontrolled essential hypertension who would reach SBP goals with the angiotensin II receptor blockers (ARBs) azilsartan medoxomil, valsartan, and olmesartan medoxomil. METHODS: A Monte Carlo simulation model was created to estimate the number of patients with hypertension (SBP ≥130 mm Hg) and diabetes who would achieve SBP goal when treated with azilsartan medoxomil, valsartan, or olmesartan medoxomil for 12 months. A cohort of 100,000 hypothetical diabetes patients with uncontrolled hypertension was created from NHANES 1999–2006 and assigned a baseline SBP. Follow-up SBPs were generated by randomly sampling from the mean and SD of the percentage change from baseline to final visit in sitting office SBPs by using data from the diabetes subpopulation from the azilsartan medoxomil clinical trial program. Mean±SD relative changes in SBP were -10.36%±10.41, -4.58%±11.04, -5.16%±11.82% (F-test P<.001) for azilsartan medoxomil, valsartan ,and olmesartan medoxomil, using the pooled efficacies across all dosages, respectively. We assessed goal attainment assuming that adherence was alternatively perfect and that 48% of patients receiving any ARB would discontinue treatment.   RESULTS: Patient characteristics based on NHANES data were mean±SD age 56±13 years, 56% male, 23% with prior cardiovascular disease, baseline SBP 151±19 mm Hg. We estimated that 41.0% of patients receiving azilsartan medoxomil would achieve SBP goal vs. 26.8% for valsartan and 28.8% for olmesartan medoxomil, assuming perfect adherence; accounting for nonadherence, 21.2%, 13.9%, and 14.8% of patients would reach SBP goals, respectively.   CONCLUSIONS: Our findings suggest that more diabetes patients treated with azilsartan medoxomil than with valsartan or olmesartan medoxomil are expected to reach SBP goal. Further analysis should address whether these differences in SBP translate into better HEDIS quality scores.