High Blood Pressure 101

Why blood pressure control is critical for people with diabetes

Blood pressure measures the force of blood pumped by your heart as it circulates throughout your body. Of the 70 million adults in the United States who have hypertension (high blood pressure) only about half have their condition under control.1 People with diabetes have higher rates of hypertension than those without diabetes (about 2 in 3 people with diabetes compared to 1 in 3 people without).

taking blood pressure

The Importance of Blood Pressure Control
Controlling your blood pressure is important because high blood pressure increases your risk of serious health complications such as heart attack and stroke, which are leading causes of death in the United States. Some risk factors for high blood pressure are beyond your control, such as age, sex, and ethnicity. However, the good news is that you can reduce your risk by:

High blood pressure causes health problems by damaging blood vessels. Small vessels, such as those in the kidneys and eyes, are often impacted first. This damage, combined with the damage caused by high blood sugar levels, means that people who have diabetes and high blood pressure are at even greater risk for conditions such as kidney disease and retinopathy (an eye disease that causes impaired or lost vision). Other conditions, such as erectile dysfunction (ED), are also associated with diabetes and high blood pressure. Erectile dysfunction has also been identified as a side effect of some medications used to treat high blood pressure.

Signs, Symptoms, and Diagnosis
High blood pressure is sometimes referred to as “the silent killer” because it is a condition that usually has no symptoms or warning signs, meaning that many people are unaware they have it. It is important to have a doctor check your blood pressure regularly—but don’t worry, it isn’t an invasive test.

Blood pressure is measured with a cuff that is inflated around your arm. This briefly squeezes the blood vessels, and when the air is released, your doctor will use a stethoscope to listen to your pulse. A pressure gauge measures the pressure when your heart beats (systolic blood pressure) and rests (diastolic blood pressure).

Blood Pressure Goals
The American Diabetes Association (ADA) recommends that blood pressure be measured at every routine visit. Blood pressure goals are as follows:3

  • Individuals with diabetes should be treated to a diastolic blood pressure (DBP) of less than 90 mmHg. (Your doctor may recommend a lower systolic target, based on certain individual factors.)
  • Individuals with diabetes and high blood pressure should be treated to a systolic blood pressure (SBP) goal of less than 140 mmHg. (Your doctor may recommend a lower systolic target, based on certain individual factors.)

Treatment Recommendations
Your healthcare provider will work with you to determine a treatment plan based on your individual blood pressure levels, risk factors, and health history. The ADA makes the following general recommendations:3

If your blood pressure is higher than 120/80 mmHg, lifestyle changes are recommended to reduce blood pressure. Lifestyle changes include:

  • weight loss, if overweight or obese
  • a diet with reduced sodium intake and increased potassium intake (such as the Dietary Approaches to Stop Hypertension, or DASH diet);
  • moderation of alcohol consumption; and
  • increased physical activity.

If your blood pressure is higher than 140/90 mmHg, medication should be prescribed in addition to lifestyle changes to reduce blood pressure. This medication regimen should include either an ACE inhibitor or an angiotensin receptor blocker (ARB). Multiple-drug therapy is often required to achieve blood pressure targets.

Updated on: February 12, 2019
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