Diabetes: High blood pressure

Hypertension with diabetes -- hypertension is an important risk factor for the development and worsening of many complications of diabetes, including diabetic eye disease and kidney disease. Hypertension affects up to 70% of people with diabetes in the UK.

Having diabetes increases your risk of developing high blood pressure and other cardiovascular problems, because diabetes adversely affects the arteries, predisposing them to atherosclerosis (narrowing of the arteries). Atherosclerosis can cause high blood pressure, which if not treated, can lead to blood vessel damage, stroke, heart failure, heart attack or kidney failure.

Compared with people with normal blood pressure readings, men and women with hypertension have an increased risk of:

• Coronary artery disease (heart disease)
• Strokes
• Peripheral vascular disease (narrowing of the arteries in the legs and feet)
• Heart failure

Even high yet normal blood pressure or pre-hypertension (defined as 120-139/ 80-89 millimetres of mercury or mmHg) has an impact on your health. Studies show that people with normal yet high range blood pressure readings, over a 10 year period of follow up time, had a two to three-fold increased risk of heart disease.

What should blood pressure be if you have diabetes?

Blood pressure readings vary, but in general your blood pressure should be less than 130/80 mmHg. The first number is the "systolic pressure" or the pressure in the arteries when your heart beats and fills the arteries with blood. The second number is the "diastolic pressure" or the pressure in the arteries when your heart rests between beats, filling itself with blood for the next contraction.

Having normal blood pressure is as important to managing diabetes as having good control of your blood sugar when it comes to preventing diabetes complications.

What are the symptoms of high blood pressure?

Usually, high blood pressure causes no symptoms. That's why it's so important to have your blood pressure checked on a regular basis (during all visits to your doctor or diabetes nurse) and to follow your doctor’s recommendations on home blood pressure monitoring.

How is high blood pressure treated?

ACE (angiotensin converting enzyme) inhibitors are a group of medicines that are often used to treat high blood pressure in people with diabetes. Although other high blood pressure medicines are available, ACE inhibitors have been shown to not only to be a useful medicine to treat high blood pressure, but it has been shown to prevent or delay the progression of kidney disease in people with diabetes.

Other medicines used to treat high blood pressure in people with diabetes include a class of medicines commonly known as ‘water pills’ or diuretics.

Because adequate control of blood pressure usually requires more than one medicine, most doctors use ACE inhibitors first then add other anti-hypertension medicines if necessary.

How do you prevent high blood pressure?

To help prevent high blood pressure:

• Stop smoking
• Eat healthily
• Maintain a healthy body weight
• Exercise
• Limit salt intake in the diet