Friday, February 23, 2024

Diabetes And High Blood Pressure Treatment

What Are The Benefits Of Exercise For Diabetes And High Blood Pressure

Diabetes High Blood Pressure (Thought Patterns That Cause Diabetes)

Exercising regularly is known to improve overall heart health, and can also contribute to lower blood pressure levels. In addition, regular exercise can also result in weight loss and better use of insulin in the body, both of which can also contribute to lowered blood pressure.

A number of studies support the benefits of physical activity and reduced blood pressure. A large analysis of studies looking at aerobic exercise in people with high blood pressure showed a reduction in blood pressure of up to 7.4 mm Hg. This improvement was seen even when people exercised as little as 30 to 60 minutes per week.

In another analysis of clinical trials of people who performed resistance exercises as part of a program to reduce blood pressure, researchers found that those who performed moderate-intensity resistance exercises at least twice per week had a decrease in both systolic and diastolic blood pressure levels.

Medication For High Blood Pressure

Making changes to your lifestyle may not be enough and many people with diabetes also need to take medication.

The most common types of blood pressure medicines are diuretics, ACE inhibitors, beta-blockers, antiotensin-2 receptor blockers and, calcium channel blockers. Ask your healthcare team if want more info on these.

Your healthcare team may give you medication even if your blood pressure isnt high and is in the target range. This is normal but you can ask your healthcare team to explain why. Its usually because the medication itself can help protect you against diabetes complications they especially protect your kidneys.

What Is The Relation Between Diabetes And Blood Pressure

Let us now understand the relation between diabetes and hypertension or high blood pressure.

There is a close relation between the two diseases: diabetes and high blood pressure and if a patient suffers from one of the above diseases, the chances of contracting the other disease are often very high. Studies show that at least 70% of the diabetes patients often suffer from the problem of high blood pressure and people with both the diseases are twice as much as those who suffer from only high blood pressure or only diabetes.

In the following paragraphs, we delve deeper and try to understand why does this correlation exist and what are the symptoms, treatment and how can a proper diet plan help in preventing the same.

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Is There A Treatment Available

As high blood pressure can lead to a number of problems in a diabetic patient and can make the treatment of diabetes extremely complicated and even impossible, it is imperative to take important measures that can lead to the prevention of the same.

A proper diet, exercise, and expert advice will help all those who suffer from the problem of high blood pressure as a result of suffering from diabetes.

How Does High Blood Pressure Affect Diabetes

High Blood Pressure Treatment in Diabetes Patients

When a person has high blood pressure along with diabetes, there are a huge number of complications that occur. If you are a diabetic patient and you suffer from high blood pressure, you are exposed to a greater possibility of getting heart diseases. Not only this, kidney problems also become rampant. A lot of eye problems such as cataract, glaucoma, and even blindness make the treatment of diabetes extremely difficult.

Hence, doctors always try to keep the blood pressure at a reasonable range especially if you suffer from diabetes. In a person without diabetes, a blood pressure reading of 140/90 is what is normal vis-à-vis a diabetic patient whose average blood pressure reading should be around 135/80.

How Common Is High Blood Pressure In People With Diabetes

In the UK, about 1 in 4 of people have high blood pressure . It is less common in younger adults. High blood pressure is more common in people with diabetes. Around 3 in 10 people with type 1 diabetes and around 8 in 10 people with type 2 diabetes develop high blood pressure at some stage.

People with diabetes are more at risk of developing high blood pressure if they:

  • Are of African-Caribbean origin.
    • Eat a lot of salt.
    • Do not eat much fruit and vegetables.
    • Do not take much exercise.
    • Drink a lot of alcohol.

Risk Factors Associated With Diabetes And High Blood Pressure

Why should those with diabetes be aware of the risks of high blood pressure? Type 2 diabetes is caused by resistance to insulin, the hormone your body needs to use blood sugar for energy. Since the bodies of those with type 2 diabetes resist insulin, sugar builds up in their blood.

That means your body makes even more insulin, and insulin causes your body to retain salt and fluids, which is one way diabetes increases your risk for high blood pressure, said Dr. Hatipoglu. Over time, diabetes damages the small blood vessels in your body, causing the walls of the blood vessels to stiffen. This increases pressure, which leads to high blood pressure.

The combination of high blood pressure and type 2 diabetes can greatly increase 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.

Chronic high blood pressure can also contribute to early onset of conditions such as Alzheimers disease, dementia, and stroke because the blood vessels in the brain are particularly susceptible to damage due to high blood pressure.

Your Blood Pressure Results

Youll get your results straight away. The reading on the monitor lets your healthcare team know whether your blood pressure is too high, too low or just right. But its important you understand your results too. Make a note of your reading at each appointment and get to know what the numbers mean.

Your healthcare team will agree a target level thats safe for you. Its important you do everything you can to keep in your target range. The longer your blood pressure is high, the more at risk you are of getting serious complications. Weve got lots of information and advice to help you bring your to the target level you’ve agreed with your healthcare team.

What Should Your Blood Pressure Be

Diabetes and high blood pressure are the most common causes of kidney disease

Readings vary, but most people with diabetes should have a blood pressure of no more than 130/80.

The first, or top, number is the “systolic pressure,” or the pressure in your arteries when your heart squeezes and fills the vessels with blood. The second, or bottom, number is the “diastolic pressure,” or the pressure in your arteries when your heart rests between beats, filling itself with blood for the next contraction.

When it comes to preventing diabetes complications, normal blood pressure is as important as good control of your blood sugar levels.

Interactions With Diabetes Medications

Hyperinsulinemia and exogenous insulin may theoretically lead to hypertension through vasoconstriction and sodium and fluid retention . However, insulin can also promote vasodilation, and basal insulin compared with standard care was not associated with a change in blood pressure in the Outcome Reduction With an Initial Glargine Intervention trial of people with type 2 diabetes or prediabetes .

Sodiumglucose cotransport 2 inhibitors are associated with a mild diuretic effect and a reduction in blood pressure of 36 mmHg systolic blood pressure and 12 mmHg diastolic blood pressure . Glucagon-like peptide 1 receptor agonists are also associated with a reduction in systolic/diastolic blood pressure of 23/01 mmHg .

People With Diabetes And High Blood Pressure Are More At Risk Of Having A Heart Attack Or Stroke So It’s Important To Know How To Look After Your Blood Pressure

If you have diabetes, you need your blood pressure checked by a healthcare professional at least once a year. This check is part of your annual review.

If your blood pressure is high , youll need treatment to bring it down. This is because it puts a strain on your blood vessels and can damage them. This can make it harder for blood to flow around the body and reach all the vital areas it needs to, like your heart. And youre more at risk of having a heart attack or stroke. It also puts you more at risk of developing all types of diabetes complications, like serious problems with your feet, your eyes and your kidneys.

Theres lots to help manage your blood pressure because your lifestyle has a direct impact. But lots of people also need to take medication to treat high blood pressure and reduce the risk complications.

Its really important to know that you might have high blood pressure and feel fine, because there arent usually any symptoms. But even if you feel healthy, high blood pressure is damaging your blood vessels and you need to get treatment. Thats why you should never miss a blood pressure check its a free test and takes two minutes.

What Is A Healthy Blood Pressure Level

Your blood pressure reading is reported with two different numbers: your systolic and diastolic readings.

According to the American Heart Association, this is the difference between the two numbers:

  • Systolic blood pressure indicates how much pressure your blood is exerting against your artery walls when the heart beats.
  • Diastolic blood pressure indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
  • Low blood pressure: either number lower than 90/60 mm Hg
  • Normal blood pressure: at or below 120/80 mm Hg
  • Hypertension stage 1: at least two readings between 130/80 and 139/89 mm Hg
  • Hypertension stage 2: at least two readings above 140/90 mm Hg
  • Hypertensive crisis: readings above 180/120 mm Hg
  • White coat hypertension: For some, going to the doctors office is so stressful it can cause high blood pressure just during the actual appointment. If you suspect this is the case for you, you can ask to be sent home with an at-home blood pressure cuff to determine what your normal day-to-day blood pressure is like.

If you suspect your blood pressure is near or above 180/120 mm Hg, visit your nearest emergency room immediately.

Diabetes And High Blood Pressure: Symptoms Risk Factors & Treatment

The risk of high blood pressure in people with diabetes

Diabetes is a chronic metabolic disease of high blood sugar. Abnormally high amounts of sugar can cause a variety of complications in almost all organs of the body, since all organs need blood. Blood that is high in sugars is concentrated, and the heart has to pump with a greater force to circulate blood throughout the body. This leads to high blood pressure, a condition that affects almost 80% of type 2 diabetics. Persistent high blood pressure can cause damage to the heart and lead to its failure. It can also increase the risks of a stroke, retinopathy and kidney disease. Lets look at the connection between diabetes and high blood pressure, their risk factors and tips for preventing these conditions.

What Should Be The Target Bp In Diabetes Mellitus

Current guidelines recommend lowering BP to < 130/80 mmHg in patients with diabetes.,, In patients with type 2 diabetes, several studies have shown the benefit of intensive BP control .,,, In the Hypertension Optimal Treatment study there was evidence that, in patients with both type 2 diabetes and hypertension, lowering BP to the lowest target level resulted in 51% reduction in major CV events as compared with the group for which the target was 90 mmHg. These findings were supported by the results from the UK Prospective Diabetes Study . In that study, tight control of BP in hypertensive patients with type 2 diabetes was associated with a reduction of 37% in microvascular-related endpoints and 44% in the risk of stroke events. Further analysis of the UKPDS showed that each 10 mmHg decrease in systolic BP was associated with 12% reduction in risk of any complication related to type 2 diabetes, without a threshold. In the Appropriate Blood Pressure Control in Diabetes trial intensive BP control had no effect on the primary endpoint, but was associated with improvement in secondary outcomes .

How To Control Blood Pressure

There are many things you can do to manage your blood pressure. Healthy eating, physical activity, managing weight and stress, and taking your medications as prescribed can all help.

Healthy eating

With time, your taste buds will adjust to the natural flavours of food without added salt.

Talk to a registered dietitian to learn more about healthy eating.

Healthy eating tips

Vegetables and fruits more often Limit processed, smoked and cured foods
Low-fat dairy products Adding salt at the table and use a minimum amount in cooking
Legumes more often Seasonings that contain the words salt or sodium, such as garlic salt, celery salt, Kosher salt, sea salt or monosodium glutamate
Whole grains, such as whole-wheat breads, cereal, pasta and brown rice Limit frozen convenience foods and fast-food restaurant meals
Lean meats and poultry without added salt
To flavour your foods with herbs, spices, fresh garlic, garlic powder, onion powder, lemon or vinegar instead of salt
To eat fish at least twice a week
Unsalted or no added salt items

Physical activity

Build physical activity into your day. Regular physical activity can improve blood pressure and heart health. Aim for 150 minutes of physical activity per week.

Check with your health-care team about the exercise routine that is suitable for you. Both aerobic and resistance exercises are recommended for people with diabetes.

Be a non-smoker

Manage stress

Limit alcohol intake


Drug Management Of Hypertension

The choice of perfect antihypertensive remains elusive and dictated by patient’s age, associated comorbidities such as chronic kidney disease , CAD, state of diabetes and hypertension, and other factors. Clinical trials with diuretics, angiotensin converting enzyme inhibitors , beta blockers, angiotensin II receptor blockers , and calcium antagonists have demonstrated benefit in the treatment of diabetic hypertensives.

ACEI are the first line in management of diabetic hypertensives. ACEIs may be used alone for BP lowering but are much more effective when combined with a thiazide-type diuretic or other antihypertensive drug. They reduce the macrovascular and microvascular risks associated with diabetic hypertensives.

  • The American Diabetes Association has recommended both ACEIs and ARBs for use in type 2 diabetic patients with CKD and other microvascular complications, because these agents delay the deterioration in glomerular filtration rate and the worsening of albuminuria. Unlike macrovascular risk reduction, microvascular risks reduction is found to be more on combining ACEI and ARBs, rather than using them alone. CALM and LORD study explains the benefit of combination of these two agents in reducing microalbuminuria.
  • The ADA has recommended ACEIs for diabetic patients > 55 years of age at high risk for CVD and Beta-blockers for those with known CAD as first-line agents.

    From various studies and guidelines, the following are observed:

    In diabetic hypertensives

    Diabetes May Contribute To Hypertension

    Diabetes, Hypertension And Kidney Disease In Young People With Dr. Chioma Nwakanma

    Elevated blood sugar stresses the blood vessels. Damage to the vessels causes them to narrow and accumulate plaque. Plaque is composed of different substances like cholesterol, fats, and waste products. Plaque buildup narrows the vessels even more and forces the heart to work harder to pump blood.

    When the heart has to work harder, the force at which the blood pumps through the body increases. This leads to high blood pressure.

    Plaque formation and buildup cause atherosclerosis. This condition can increase the risk of heart attack, stroke, and peripheral arterial disease . PAD can include any number of diseases that impact the arteries that carry blood to distant parts of the body.

    Guidelines For Managing Diabetic Hypertensives

  • The target BP should be below 130/80 mm Hg.
  • All routinely used antihypertensive drugs have been shown to be beneficial compared with placebo.
  • More than one drug will usually be required to achieve the target BP.
  • Patients with prehypertension should be given lifestyle/behavioral therapy alone for a maximum of 3 months and then, if targets are not achieved, should also be treate d pharmacologically. Attention should be paid to lifestyle changes , as well as control of hyperglycemia, dyslipidemia, and proteinuria, for all the patients.
  • The choice of drugs should always include an ACE inhibitor and should usually include a diuretic. If additional therapy is needed, a calcium-channel blocker, -blocker, or -blocker may be used .
  • Causes And Risk Factors Of High Blood Pressure

    For most people, theres no single cause of high blood pressure. But we know some things can make you more at risk. These are called risk factors, and one of these is having diabetes.

    High levels of sugar in your blood can lead to something called atherosclerosis. This is when theres a build-up of fatty material inside your blood vessels, narrowing them. The narrower the blood vessels, the more the pressure builds up.

    The more stress your blood vessels are under, the harder it is to push blood around the important areas of your body. This means your feet, eyes and heart are seriously at risk.

    There are other risk factors you cant do much about:

    • your age
    • a family history of high blood pressure
    • if your ethnic background is African-Caribbean or Black African

    And there are risk factors you do have control over:

    • too much salt in your diet
    • being overweight
    • how you cope with stress
    • drinking too much caffeine, such as coffee

    If you make changes to your diet and lifestyle, you can reduce your risk of developing high blood pressure. Were not saying its easy, but its vital you understand how you can do this. Theres lots of support to help you and achieve your goals.

    Approach To The Patient

    Most patients with diabetes require combination therapy to attain a blood pressure of less than 130/80 mm Hg.2,79 Antihypertensive medications with different mechanisms of action should be used. Many fixed-dose combinations are available and should be considered if more than one agent is needed to control blood pressure.3Figure 1 provides a suggested approach to the management of hypertension in patients with diabetes.79

    When the target blood pressure is not achieved with lifestyle modifications, ACE inhibitors are recommended as first-line therapy.2,8,9 ARBs may be used in patients who cannot tolerate ACE inhibitors. If adequate titration of the ACE inhibitor or ARB does not provide satisfactory blood pressure reduction, the addition of a thiazide diuretic is the next step.8,9 In patients with significant renal insufficiency, a loop diuretic may be used instead however, there is not sufficient data from clinical trials to support this recommendation. For most patients, beta blockers or CCBs are third-line agents.9

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