Latar belakang: Terlepas dari riwayat hipertensi (HTN), ditemukan bahwa tekanan darah sistolik (TDS) memiliki pengaruh signifikan terhadap keparahan neuropati perifer diabetik (NPD). Namun, kontrol tekanan darah belum banyak dilibatkan dalam penanganan NPD. Selain itu, sumber literatur yang membahas topik ini masih sangat terbatas dan memiliki konklusi yang kontradiktif. Tujuan penelitian: Mengetahui hubungan antara TDS dan tingkat keparahan neuropati perifer (NP) pada penderita diabetes melitus tipe 2 (DM2). Metode: Data diperoleh dari pasien DM tipe 2 RSU Siloam Lippo Village poliklinik penyakit dalam dengan wawancara, pengukuran TDS sewaktu, pengisian kuesioner painDETECT dan NSS, serta pengumpulan data rekam medis. Hasil: Sebanyak 78 sampel yang terkumpul merupakan pasien dengan rata-rata usia 61,4 tahun, 71,7% dibawah 65 tahun, 61,5% perempuan, 66,7% penderita DM tidak terkontrol, 10,3% perokok dengan pack year >30, 76,9% IMT >22.9, 27.4% dengan durasi DM2 >10 tahun, dan 80,7% memiliki riwayat hipertensi. Hasil analisis Chi-square menunjukan bahwa TDS memengaruhi keparahan NPD secara signifikan, dimana pasien dengan TDS HTN memiliki risiko 8.8 kali lebih tinggi mengalami keparahan NPD lebih berat. Hasil uji regresi logistik ganda dengan variabel yang memenuhi kriteria yaitu TDS, IMT, riwayat pack year, dan durasi DM2 menunjukkan bahwa, TDS merupakan faktor yang paling signifikan memengaruhi keparahan NPD (p 0,006; OR 8,839; 95% CI = 1,859-42,022). Kesimpulan: Terlepas dari kondisi HTN, ditemukan bahwa TDS Hipertensi secara signifikan memengaruhi keparahan NPD penderita DM tipe 2. Kata kunci: tekanan darah sistolik, hipertensi, neuropati perifer, diabetes melitus tipe 2 / Background: Regardless of hypertension (HTN) history, systolic blood pressure (SBP) significantly influences diabetic peripheral neuropathy (DPN) severity. However, blood pressure control is not widely incorporated in DPN management. Moreover, the literature on this topic is limited and often contradictory. Objective: To determine the relationship between SBP and the severity of neuropathy in type 2 diabetes mellitus (T2DM) patients. Methods: Data were collected from T2DM patients at Siloam Hospital Lippo Village internal medicine outpatient clinic through interviews, SBP measurements, painDETECT and NSS questionnaires, and medical records. Results: Among 78 patients, the average age was 61.4 years, 71.7% <65 years, 61.5% were female, 66.7% had uncontrolled diabetes, 10.3% were smokers with >30 pack years, 76.9% had a BMI >22.9, 27.4% had diabetes duration >10 years, and 80.7% had a history of hypertension. Chi-square analysis indicated that SBP significantly affects DPN severity, with patients having hypertensive SBP being 8.8 times more likely to experience severe DPN. Multiple logistic regression analysis, including variables SBP, BMI, smoking history, and T2DM duration, revealed that SBP is the most significant factor influencing DPN severity (p-value 0.006; OR 8.839; 95% CI = 1.859-42.022). Conclusion: Regardless of HTN status, hypertensive SBP significantly influences the severity of DPN in T2DM patients. Keywords: systolic blood pressure, hypertension, diabetic peripheral neuropathy, type 2 diabetes mellitus