Type 2 diabetes and hypertension overlap in the population. In many subjects, development of diabetes is characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs during the development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during the development of hypertension in patients with or without diabetes using data from the Mexico City Diabetes Study (MCDS, a population-based study of diabetes in Hispanic Whites) and in the Framingham Offspring Study (FOS, a community-based study in non-Hispanic Whites) over a 7-year follow-up. Diabetes at baseline was a significant predictor of incident hypertension (in FOS, OR=3.14 [95% CI=2.17–4.54]) independently of gender, age, BMI, and familial diabetes. Conversely, hypertension at baseline was an independent predictor of incident diabetes (in FOS, OR=3.33 [95% CI=2.50–4.44]). In >60% of the converters, progression from normotension to hypertension was characterized by a steep increase in BP values, averaging 20 mmHg for systolic BP within 3.5 years (in MCDS). In comparison with the non-converters group, hypertension and diabetes converters shared a metabolic syndrome phenotype (hyperinsulinemia, higher BMI, waist girth, BP, heart rate and pulse pressure, dyslipidemia). Overall, results were similar in the two ethnic groups. We conclude that (1) development of hypertension and diabetes track each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BP values, and (3) insulin resistance is one common feature of both prediabetes and prehypertension, and an antecedent of progression to two respective disease states