Blood Pressure Management and Diabetes

Guest Post, David Mapletoft, Diabetes Educator

Often diabetes and high blood pressure (hypertension) go hand-in-hand.  It is thought that 40 to 50 percent of people with diabetes have high blood pressure as well.  High blood pressure, like diabetes, is a lifelong  disease.  It can be treated but not cured.  If you have both diabetes and high blood pressure, it will be especially important to work closely with your doctor and other healthcare professionals to control both.

Blood pressure is the amount of force your blood exerts against the walls of your blood vessels.  Blood pressure is usually measured as two numbers, such as 120/80 (normal blood pressure).  The first and larger number (systolic pressure) is the blood pressure during a contraction (beat) of the heart.  The second and smaller number (diastolic pressure) is the blood pressure when the heart is at rest (between beats).  Your blood pressure can change many times during the day depending on physical activity, emotional state, and other reasons.

Therefore a number of blood pressure readings are needed before a diagnosis of high blood pressure (hypertension) can be made.  Blood pressure readings above 140/90 on two or more occasions mean you have high blood pressure regardless of age.  For the person with diabetes who is found to have high blood pressure too, most diabetes specialists believe that the target of treatment of that high blood pressure should be less than 130/80 regardless of age.

Sometimes blood pressure that is too high will cause dizziness, headaches, or nosebleeds.  Most often, however, high blood pressure causes no outward signs of trouble.  Because of this, high blood pressure is often referred to as a “silent” disease.  It can be missed in people who do not have their blood pressure checked regularly.  Because usually there are no symptoms, people who have high blood pressure sometimes stop taking their medicine because they feel okay.  This is a serious mistake.

High blood pressure that is not treated can lead to a heart attack, stroke or kidney failure.

If you have diabetes and high blood pressure, it is very important to take care of them both.  High blood pressure can cause the complications of diabetes to be worse.  High blood pressure can speed up the process of hardening of the arteries and kidney disease.  This leads to an increased risk of heart attack, stroke, and kidney failure.  High blood pressure further weakens damaged blood vessels in the eyes, and can make blood flow problems in the feet and legs worse.  Taking good care of your diabetes and high blood pressure can decrease, delay, and sometimes prevent these problems.

The care of high blood pressure is somewhat like the care of diabetes.  In fact, sometimes the same treatment works for both of them.  Many people with diabetes and high blood pressure are overweight.  Weight loss and regular exercise will often help control both diabetes and high blood pressure.  People with high blood pressure can also cut down on salt and regularly take any medicine prescribed.  By working with your health care team and following your treatment, you can meet the challenge of caring for diabetes and high blood pressure.

 Questions to ask you doctor:

What is my blood pressure?

If it is above 130/80, what’s the plan? E.g. should I start medication?, have my medication increased?, start a second (or third) type of blood pressure medication?, or have my blood pressure measured again next week?

If my blood pressure in unable to be managed well between us, when can I consult a blood pressure (often a kidney) specialist?

David Mapletoft

David is a Diabetes Educator, Midwife, Photographer and Health Coach