High blood pressure, or hypertension, is a condition that’s seen in people with type 2 diabetes. It’s unknown why there’s such a significant relationship between the two diseases. It’s believed that the following contribute to both conditions:
- a diet high in fat and sodium
- chronic inflammation
High blood pressure is known as a “silent killer” because it often has no obvious symptoms and many people are unaware they have it. A 2013 survey by the American Diabetes Association (ADA) found that fewer than half of people at risk for heart disease or type 2 diabetes reported discussing biomarkers, including blood pressure, with their care providers.
When is it high blood pressure?
If you have high blood pressure, it means that your blood is pumping through your heart and blood vessels with too much force. Over time, consistently high blood pressure tires the heart muscle and can enlarge it. In 2008, 67 percent of American adults aged 20 and over with self-reported diabetes had blood pressure rates that were greater than 140/90 millimeters of mercury (mm Hg).
In the general population and in people with diabetes, a blood pressure reading of less than 120/80 mm Hg is considered normal.
What does this mean? The first number (120) is called the systolic pressure. It indicates the highest pressure exerted as blood pushes through your heart. The second number (80) is called the diastolic pressure. This is the pressure maintained by the arteries when the vessels are relaxed between heartbeats.
According to the American Heart Association (AHA), healthy people over 20 with a blood pressure lower than 120/80 should get their blood pressure checked once every two years. People with diabetes need to be more vigilant.
If you have diabetes, your doctor may check your blood pressure at least four times each year. If you have diabetes and high blood pressure, the ADA recommends that you self-monitor at home, record the readings, and share them with your doctor.
Risk factors for high blood pressure with diabetes
According to the ADA, the combination of high blood pressure and type 2 diabetes is particularly lethal and can significantly raise your risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease and retinopathy. Diabetic retinopathy may cause blindness.
There’s also significant evidence to show that chronic high blood pressure can speed the arrival of problems with the ability to think that are associated with aging, such as Alzheimer’s disease and dementia. According to the AHA, blood vessels in the brain are particularly susceptible to damage due to high blood pressure. This makes it a major risk factor for stroke and dementia.
Uncontrolled diabetes isn’t the only health factor that increases risk for high blood pressure. Remember, your chances of having a heart attack or stroke increase exponentially if you have more than one of the following risk factors:
- family history of heart disease
- high-fat, high-sodium diet
- sedentary lifestyle
- high cholesterol
- advanced age
- current smoking habit
- too much alcohol
- chronic diseases such as kidney disease, diabetes, or sleep apnea
An older study from 2003 has shown that women who have gestational diabetes are more likely to have high blood pressure. However, women who manage their blood sugar levels during pregnancy are less likely to experience high blood pressure.
If you develop high blood pressure during pregnancy, your doctor will monitor your urine protein levels. High urine protein levels may be a sign of preeclampsia. This is a type of high blood pressure that occurs during pregnancy. Other markers in the blood may also lead to a diagnosis. These markers include:
Preventing high blood pressure with diabetes
There are many lifestyle changes that can lower your blood pressure. Nearly all are dietary, but daily exercise is also recommended. Most doctors advise walking briskly for 30 to 40 minutes every day, but any aerobic activity can make your heart healthier.
The AHA recommends a minimum of either:
- 150 minutes per week of moderate-intensity exercise
- 75 minutes per week of vigorous exercise
- a combination of moderate and vigorous activity each week
In addition to lowering blood pressure, physical activity can strengthen the heart muscle. It may also reduce arterial stiffness. This happens as people age, but is often accelerated by type 2 diabetes. Exercise can also help you gain better control of your blood sugar levels.
Work directly with your doctor to develop an exercise plan. This is especially important if you:
- haven’t exercised before
- are trying to work up to something more strenuous
- are having trouble meeting your goals
Start with five minutes of brisk walking each day and increase it over time. Take the stairs instead of the elevator, or park your car farther from the store entrance.
- high-fat meats
- whole-fat dairy products
According to the ADA, there are many eating plan options for people with diabetes. Healthy choices that can be maintained over a lifetime are the most successful. The DASH (Dietary Approaches to Stopping Hypertension) diet is one diet plan specifically designed to help lower blood pressure. Try these DASH-inspired tips for improving the standard American diet:
A healthier diet
- Fill up on several servings of vegetables throughout the day.
- Switch to low-fat dairy products.
- Limit processed foods. Make sure they contain fewer than 140 milligrams (mg) of sodium per serving or 400-600 mg per serving for a meal.
- Limit table salt.
- Choose lean meats, fish, or meat substitutes.
- Cook using low-fat methods such as grilling, broiling, and baking.
- Avoid fried foods.
- Eat fresh fruit.
- Eat more whole, unprocessed foods.
- Switch to brown rice and whole-grain pastas and breads.
- Eat smaller meals.
- Switch to a 9-inch eating plate.
Treating high blood pressure with diabetes
While some people can improve their type 2 diabetes and high blood pressure with lifestyle changes, most require medication. Depending on their overall health, some people may need more than one medication to help manage their blood pressure. Most high blood pressure medications fall into one of these categories:
- angiotensin-converting enzyme (ACE) inhibitors
- angiotensin II receptor blockers (ARBs)
- calcium channel blockers
Some medications produce side effects, so keep track of how you feel. Be sure to discuss any other drugs you’re taking with your doctor.