OBJECTIVES: Risk of cardiovascular disease death is 2-4 times higher in diabetics than non-diabetics, and control of hypertension reduces this risk by up to 50%. While there are numerous drug classes available for hypertension treatment, the American Diabetes Association (ADA) specifically recommends ACE inhibitors or ARBs because they offer additional vascular benefits in diabetes.  Further, the ADA suggests that multi-drug therapy is usually required to achieve blood pressure targets.  The objective of this study is to examine the prescribing patterns of antihypertensive medications among diabetics relative the ADA recommendations. METHODS: Data from the 2008 National Ambulatory Medical Care Survey (NAMCS) was utilized to identify office visits involving diabetic patients.  This nationally representative sample of US physician-patient office visits utilizes a multi-staged sampling technique to collect several demographic and clinical parameters on patient visits as well as information on up to eight continuous or newly prescribed medications.  Diabetes was identified by a physician questionnaire regarding presence of patient comorbidities and medications were identified using US National Drug Codes.   RESULTS: Of the 28,741 office visits collected, 2,955 were among diabetic patients and 49.3% (n=1,456) of the diabetic patients were prescribed at least one antihypertensive medication.  ACE inhibitors were the most frequently prescribed (40.9%), followed by beta blockers (39.4%), diuretics (30.2%), and calcium channel blockers (20.5%).  ARBs were less frequently prescribed (20%).  Over half (51.9%) were prescribed 2 or more hypertensive medications. CONCLUSIONS: Based on data from the National Ambulatory Medical Care Survey, it appears that ADA recommendations for hypertensive therapy in diabetics are being followed with regard to ACE inhibitors and polytherapy.  ARBs, however, appear less common in the population with other antihypertensive classes being prescribed more frequently. Future studies involving longitudinal data are needed to evaluate trending in the adherence to ADA recommendations for hypertensive therapy.