TREATING HYPERTENSION AND DIABETES
People with diabetes often have hypertension as well. But these don’t need to be lifelong problems: Changes in eating and exercise habits can help.
People with diabetes have an increased chance of developing high blood pressure, also known as hypertension. In fact, hypertension is twice as likely in people with diabetes as it is in people who don’t have diabetes.
Almost 24 million people in the United States have diabetes — that’s about 8 percent of the entire population. And up to 60 percent of people with diabetes also have hypertension. Almost one-third of all those with high blood pressure and diabetes are unaware that they have hypertension, and 43 percent of those with diabetes who have high blood pressure go untreated.
People with diabetes “are at higher risk for vascular disease, coronary artery disease, and cerebral vascular disease, which results in heart attacks and strokes,” says Curtis Rimmerman, MD, staff cardiologist and echocardiographer at the Cleveland Clinic in Cleveland. “Oftentimes high blood pressure has a genetic component. Either way, controlling risk factors is important. There are [people with diabetes] who lead very healthy lifestyles and don’t develop high blood pressure. But there’s a tendency to be more overweight and more sedentary and have higher cholesterol levels, too.”
Gaining Control of Both Conditions
It’s very important to control hypertension because, like diabetes, it can lead to other health complications. If your blood travels through vessels with extra force due to hypertension, your heart must work harder and, as a result, your risks of cardiovascular diseases increase. The American Diabetes Association recommends aiming for blood pressure that’s less than 130/80 mmHg (millimeters of mercury) if you have diabetes. “The lower the better,” Dr. Rimmerman says.
The Best Medicines for High Blood Pressure and Diabetes
Having diabetes may also impact which hypertension medications your doctor chooses. “Most medications are fairly equivalent, but some are beneficial for both high blood pressure and diabetes,” says Rimmerman.
For example, angiotensin-converting enzyme (ACE) inhibitors are a class of drugs that slow down the effects of diabetes on the kidneys and reduce the incidence of proteinuria, a sign of chronic kidney disease and a complication of diabetes. They also work to lower your blood pressure by relaxing blood vessels and preventing them from narrowing.
“Most people with diabetes will optimally be placed on ACE inhibitors for blood pressure control,” Rimmerman says.
Other medications typically prescribed for high blood pressure that occurs with diabetes include:
Beta blockers, which help your heart to beat slower and with less force, ultimately reducing your blood pressure
Calcium channel blockers
Diuretics to decrease water and sodium (which tend to increase your blood pressure) through urination
High Blood Pressure and Diabetes: Breaking the Connection
“Both diseases are modifiable,” Rimmerman says. “Just because you’ve been diagnosed with both doesn’t mean you’ll live with both forever. Type 2 diabetes is modifiable by refining your diet, body weight, and adding more exercise. When this is done, sometimes diabetes medication requirements decline and blood pressure medication requirements can diminish, too.”
By Lynn Yoffee | Medically reviewed by Pat F. Bass III, MD, MPH