Diabetes And Hypertension: A Dangerous Duo
If you have diabetes, you already know about the importance of controlling your blood sugar levels. But you may not be aware of another problem that can go hand-in-hand with diabetes high blood pressure or hypertension.
There is a strong connection between diabetes and hypertension, explains Jai Radhakrishnan, MD, Director of Clinical Services of the Nephrology Division and Co-Director of the Hypertension Center at Columbia University Medical Center. Two out of every three people with Type 2 diabetes also have high blood pressure or take prescription medications to lower their blood pressure. Both are diseases of lifestyle and aging and share common risk factors. The good news is that diabetes and hypertension can be modified through behavior, including eating a healthful diet, exercise, weight control and, if your doctor prescribes it, medication.
People with diabetes either do not have enough insulin to process glucose or their insulin does not work effectively. As a result, glucose accumulates in the bloodstream, which can cause widespread damage to the blood vessels and kidneys.
Diabetes is the number one cause of kidney failure in the US, and one third of diabetics develop kidney disease
People with both diabetes and hypertension have approximately twice the risk of heart attack and stroke as nondiabetic people with hypertension. Hypertensive diabetic patients are also at increased risk for complications including retinopathy and kidney disease.
Risk Factors And Connection
Some of the major driving factors for both diabetes and high blood pressure include living a sedentary lifestyle and excessive calorie intake. Having diabetes also increases your risk of high blood pressure. Insulin resistance in people with diabetes increases your risk as well.
High blood pressure and diabetes are closely linked due to a number of common risk factors, including blood vessel inflammation, atherosclerosis , and dyslipidemia .
Other risk factors for high blood pressure include:
- excessive consumption of alcohol or caffeine
- the way you cope with stress
- a family history of high blood pressure
Additionally, environmental, social, and economic inequities can lead to the development of diabetes and high blood pressure. Black Americans are disproportionately affected by high blood pressure, partly due to food deserts and environmental pollution.
Types Of Diabetes And Their Symptoms
There are three kinds of diabetes, all of which have different causes:
Type 1 diabetes
Type 1 diabetes is an autoimmune disorder in which the body mistakenly attacks cells in the pancreas that produce insulin. The disease tends to appear during childhood or adolescence, though it can occur later in life.
Type 2 diabetes
Type 2 diabetes occurs as a result of insulin resistance. This is where body cells lose their ability to respond to insulin. The pancreas tries to compensate by producing more insulin, but the process is not sustainable.
Current guidelines recommend diabetes screening for everyone ages 45 years or above, and anyone younger who has risk factors for the disease. Early diagnosis and treatment can help slow or even reverse the disease, reducing the risk of complications.
does not have enough insulin to process glucose or their insulin does not work effectively. Insulin is the hormone that enables the body to process glucose from food and use it as energy.
When a person has insulin problems, glucose cannot enter their cells to provide energy, so it accumulates in the bloodstream instead.
High blood glucose levels can cause widespread damage to tissues and organs, including those that play a key role in maintaining healthy blood pressure. For example, damage to the blood vessels and kidneys can cause blood pressure to rise.
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Treatment Of Diabetes Mellitus And Its Cardiovascular Complications
Once T2D has been diagnosed, the aim of achieving glucose control is principally to avoid microvascular complications. There are some benefits with respect to macrovascular complications, but this is dependent on the profile of individual drug classes and even appears to be different for agents within the same class.88 The role of BP lowering to improve prognosis in T2D has been established since the UK Prospective Diabetes Study in 1998.89, 90 However, more recently, more widespread use of glucose-lowering agents that reduce weight, lower BP, and have beneficial off-target effects facilitates cardiovascular risk factor control and is playing a role in improving the cardiovascular prognosis of T2D.91, 92
Achieving glucose control in T2D begins with weight management. Particularly in the first 8 years after diagnosis, normal glucose tolerance can be restored if radical weight reduction can be achieved, most effectively using a very low calorie liquid replacement diet.93 In obese patients, this can also occur after successful bariatric surgery, particularly the Roux-en-Y procedure.94 The mechanism may involve reduction in ectopic fat, and consequent relief from its proinflammatory effects, in and around the pancreatic islets of Langerhans.95
What Is Blood Pressure
Blood pressure is the pressure your heart uses to push blood through your blood vessels and around your body.
There are two numbers used to describe blood pressure and its measured in millimetres of mercury . Its written like this: 130/80mmHg. And youll hear your doctor say â130 over 80â.
The first number is the systolic pressure. This is the most amount of pressure your heart uses when beating to push the blood around your body.
The second number is the diastolic pressure. This is the least amount of pressure your heart uses when it is relaxed between beats.
Using 130/80mmHg as an example, the systolic pressure here is 130mmHg and the diastolic pressure is 80mmHg.
Our video below explains all about blood pressure, and how it affects people with diabetes.
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What To Read Next
Eat healthy for diabetes: The one article you need to read about diabetes and diet.
Free Diabetes Food Guide: Understand which food to choose, and how much to eat at each meal.
Meal plans:Whether youre looking for a budget meal plan, low carb meal plan, vegetarian or easy cooking we have them all here, for free!
How Does Diabetes Impact Blood Pressure
Untreated or unmanaged diabetes leads to chronically high blood sugars. When excess sugar is circulating through our blood, eventually our small blood vessels are damaged. When our blood vessels are injured, they stiffen and narrow, which eventually leads to high blood pressure. Because both diabetes and high blood pressure can be present without obvious symptoms, it’s best to seek regular and preventive medical care with your primary care provider. Of course, living a healthy lifestyle with regular exercise and a nutritious diet is a great prevention strategy too!
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How To Lower Your Blood Pressure
A lot of lowering your blood pressure is down to making positive lifestyle changes. But we know its not always that straightforward, and some people will need medication to help too.
- Try different ways to cope with stress
- Have less caffeine
Your healthcare team can support you with making these changes. Find out what healthcare checks and services you are entitled to.
Keeping Your Blood Pressure In Check
If you are diabetic, keeping an eye on your blood pressure is key. Your doctor will help you to do so and recommend drugs if necessary. But, there are several steps you can take to work toward reducing your blood pressure, including dietary changes and regular exercise.
Make sure to have your blood pressure checked frequently, as high blood pressure often doesnt produce any noticeable symptoms.
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Type 2 Diabetes Mellitus And Hypertension
The prevalence of obesity and type 2 diabetes continues to rise worldwide as lifestyles associated with low energy expenditure and high caloric intake are increasingly adopted, particularly in lower-income and developing countries. It is predicted that the number of cases of T2D will rise from 415 million to 642 million by 2040.1 Hypertension is even more common, rising in prevalence in the same countries, with a recent worldwide estimate of 1.39 billion cases.2
Although T2D and hypertension can be simply diagnosed at the bedside, they are each complex and heterogeneous phenotypes associated with an elevated risk of life-threatening cardiovascular disease . Their frequent coexistence in the same individual is not a coincidence, because aspects of the pathophysiology are shared by both conditions, particularly those related to obesity and insulin resistance. For example, in the San Antonio Heart Study, 85% of those with T2D had hypertension by the fifth decade of life, whereas 50% of those with hypertension experienced impaired glucose tolerance or T2D.3
Vascular processes whereby diabetes and hypertension predispose to cardiovascular disease. Common risk factors promote diabetes and hypertension, which are associated with atherosclerosis, vascular inflammation, endothelial dysfunction, and structural remodelling, which lead to macrovascular and microvascular disease. Vascular damage and endothelial dysfunction is amplified when diabetes and hypertension coexist.
Treatment And Prevention Of High Blood Pressure In People With Type 2 Diabetes
The recommended treatment and steps for prevention of high blood pressure are not much different than the treatment and prevention of type 2 diabetes.
It is well documented that lifestyle changes can lower blood pressure as much as pills can, and sometimes even more, says Dr. Fisher from the Harvard Medical School.
Lets take a look.
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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:
- 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.
Diabetes May Contribute To Hypertension
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.
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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 .
The Connection Between Diabetes Kidney Disease And High Blood Pressure
Please note: This article was published more than two years ago, so some information may be outdated. If you have questions about your health, always contact a health care professional.
It’s a triple health threat faced by tens of millions of Americans. But few think about it until they’re forced to.
Even then, the interplay between diabetes, high blood pressure and kidney disease can be a challenge for people to grasp. But doctors say having an understanding is key for anybody who wants to reduce their risk or already has the conditions, or who helps a family member with them.
It’s especially important for people who could benefit from new medications but face barriers slowing their use.
More than 34 million people, or 10.5% of the U.S. population, have diabetes, according to the Centers for Disease Control and Prevention. Most cases are Type 2, or adult-onset. When someone has diabetes, they can’t make or use insulin as well as they should. That causes blood sugar to rise, which leads to various complications throughout the body.
Dr. Vivek Bhalla, an associate professor of medicine and nephrology at Stanford University School of Medicine in California, summed it up: “Diabetes can affect small blood vessels. And that can result in hypertension. And that can also result in kidney disease.”
It can be a vicious cycle, said Bhalla, past chair of the American Heart Association’s Council on the Kidney in Cardiovascular Disease.
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How Are High Blood Pressure And Diabetes Linked
High blood pressure and diabetes dont cause one another, but people with type 2 diabetes tend to have other health problems at the same time, including high blood pressure and high blood cholesterol. These can all individually damage the blood vessels, leading to heart disease, stroke, kidney disease and other problems, but having them all together raises the risk even more.
If you are diagnosed with diabetes your GP will want to manage all these health problems to prevent a heart attack or stroke.
Randomized Clinical Trials Of Intensive Blood Pressure Control
The ACCORD blood pressure trial examined the effects of intensive blood pressure control versus standard blood pressure control among people with type 2 diabetes. Additional studies, such as Hypertension Optimal Treatment trial and SPRINT, also examined the potential benefits of intensive versus standard blood pressure control, though the relevance of their results to people with diabetes is less clear. The Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled EvaluationBlood Pressure trial, which tested the effects of a fixed-dose combination of antihypertensive interventions versus placebo among people with type 2 diabetes, also informs blood pressure targets . Study details are given in .
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Best Foods To Eat If You Have Diabetes And High Blood Pressure
Diabetes statistics show people with diabetes are twice as likely to develop high blood pressure than people without the condition, according to experts at Johns Hopkins University School of Medicine. And high blood pressure, scientifically known as hypertension, increases the risk of heart attack, stroke and heart disease.
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So if you have both diabetes and hypertension, it’s important to follow a meal plan that manages both conditions and reduces your risk of further health complications. Jo-Anne Rizzotto, RDN and director of educational services at Harvard’s Joslin Diabetes Center, typically recommends the DASH diet for people with both complications.
One of the most important components of the DASH diet is reducing sodium intake: Salt causes the body to retain water, which raises blood pressure, according to the American Heart Association . But it’s not just about eating less salt. A well-balanced diet is critical for your overall good health.
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That’s why the DASH diet is rich in fresh vegetables, fruits, whole grains, lean proteins, nuts and legumes including nutrients that are linked to lower blood pressure, including potassium, calcium, magnesium and fiber. The plan is also low in sodium and processed foods. So consider stocking up on this food list for diabetes and high blood pressure during your next grocery run.
Diabetes And High Blood Pressure Raise Your Risk Of Having A Stroke Or Heart Attack And Having Both Together Raises Your Risk Much More Than Having Either One Alone
Type 2 diabetes is becoming more common in the UK, but like it often has no symptoms, so people dont know they have it and arent getting the support they need to prevent problems later on.
The good news is there are simple checks you can have to find out if you have diabetes, pre-diabetes or high blood pressure, and then there are steps you can take to prevent them or keep them under control.
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The Pros And Cons Of Pain Relief Drugs
Here’s a rundown of the benefits and risks of some popular pain medications. It should help simplify your choices the next time you’re in the drugstore.
Keep in mind that you shouldn’t use any over-the-counter painkiller on a regular basis. If you’re in that much pain, you need to talk with your doctor.
ACETAMINOPHENTylenol, Panadol, Tempra
- How it works. Acetaminophen is not an NSAID. Experts aren’t actually sure how it works, but it seems to affect chemicals that increase the feeling of pain.
- Benefits. Acetaminophen reduces pain and lowers fevers. Experts believe that acetaminophen is safe for people with high blood pressure.Acetaminophen is also less likely to cause gastrointestinal problems than NSAIDs. It is safe for women who are pregnant and nursing.
- Side effects and risks. Experts believe that acetaminophen is safe for people with high blood pressure. Very high doses of acetaminophen can cause serious liver damage. Long-term use of acetaminophen in high doses — especially when combined with caffeine or codeine can cause kidney disease. Acetaminophen doesn’t reduce swelling, like aspirin and other NSAIDs do. It may be less helpful in treating pain that’s caused by inflammation, such as some types of arthritis.
ASPIRINBayer, Bufferin, Ecotrin
IBUPROFEN