Nearly 1 in 3 American adults has high blood pressure and 2 in 3 people with diabetes report having high blood pressure or take prescription medications to lower their blood pressure, according to the American Diabetes Association, (ADA).
Blood pressure increases when arteries are narrowed, due to atherosclerosis or to chronically high blood glucose levels, and blood flow is restricted.
The long-term stress of high blood pressure levels increases the risk of other diabetic complications such as stroke, coronary artery disease (CAD), diabetic retinopathy, and nephropathy (kidney disease).
What is blood pressure?
Blood pressure is the force of blood flow inside your blood vessels. Your doctor records your blood pressure as two numbers, such as 120/80, which you may hear them say as “120 over 80.” It is important to understand what both numbers mean.
The first number also called the “systolic” is the pressure as your heart beats and pushes blood through the blood vessels. The second number is the pressure when the vessels relax between heartbeats. It’s called the “diastolic” pressure.
What do the numbers mean?
- Healthy blood pressure: below 120/80
- Early high blood pressure: between 120/80 and 140/90
- High blood pressure: 140/90 or higher
According to the ADA, the lower your blood pressure, the better your chances of delaying or preventing a heart attack or a stroke.
When your blood moves through your vessels with too much force, you have high blood pressure or hypertension. Your heart has to work harder when blood pressure is high, and your risk for heart disease and diabetes goes up.
High blood pressure raises your risk for heart attack, stroke, eye problems, and kidney disease. High blood pressure is a problem that won’t go away without treatment and changes to your diet and lifestyle.
Keep Track of your numbers:
You should measure your blood pressure at consistent times and always keep track of your numbers.
Blood pressure is measured with a cuff device. The numbers that are given as your blood pressure results (e.g., 130 over 80) are systolic and diastolic pressure readings, respectively.
The systolic reading represents your blood pressure as your heart beats, while the diastolic is the pressure between beats.
With hypertension, both systolic and diastolic readings may be high, or the systolic alone may be high, a condition also known as isolated systolic hypertension (ISH). Both types can lead to serious complications if not treated appropriately.
Normal blood pressure is defined as 120/80 mmHg for people without diabetes and <130/80 mmHg for those with diabetes and/or chronic kidney disease.
Blood pressure measurements fall into four general categories:
- Normal blood pressure. Your blood pressure is normal if it’s below 120/80 mm Hg.
- Elevated blood pressure. Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure.
- Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 130 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg.
- Stage 2 hypertension. More severe hypertension, stage 2 hypertension is a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher.
Since high blood pressure is frequently a “silent” condition with few to no symptoms, it’s important to have your blood pressure taken every time you visit your diabetes care provider.
You can also purchase a blood pressure cuff device to take home readings. Talk to your doctor about recommendations for equipment and testing.
In most cases of mild or even moderate hypertension, there are no symptoms. However, people with extremely elevated blood pressure may experience:
- A headache
- Vision problems
- Abdominal or chest pain
- Shortness of breath
Medications that may be prescribed to reduce blood pressure include diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta-blockers, and calcium channel blockers.
The American Diabetes Association also recommends that most adults (i.e., over 21) with diabetes who have a history of risk factors for CAD, PVD, hypertension, or heart attack take a daily dose of coated aspirin.
Other strategies for prevention:
- Stay at a healthy body weight. Excess pounds promote hypertension.
- Keep active. Exercise can help lower your blood pressure.
- Eat a balanced diet low in saturated and total fat, cholesterol, and sodium and rich in vegetables, fruit, and nonfat dairy (the DASH, or Dietary Approaches to Stop Hypertension, diet).
- Quit smoking. Nicotine raises blood pressure.
- Keep alcohol intake at a moderate level.
- Practice good stress management.
- Emotional or physical stress can raise blood pressure; talk to your provider about relaxation techniques and strategies.
Reviewed by Francine Kaufman, MD.