Diabetes Basics
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Hypertension and Diabetes

What to know about high blood pressure

According to the American Diabetes Association, nearly one in three American adults has high blood pressure. But, as many as two out of three people with diabetes report having high blood pressure or take prescription medication to lower their blood pressure. Just as good control of your blood sugar levels is important to prevent diabetes complications, so is maintaining normal blood pressure. Here is some information to help you learn more about blood pressure.

What is blood pressure?

Blood pressure is the force of blood inside the blood vessels. It is recorded as two numbers: systolic and diastolic, and written as a ratio, for example, 120/80. Both numbers are important.

Systolic is the top and higher number in the ratio.  It measures the pressure in the blood vessels as the heart beats. The bottom and lower number, diastolic, measures the pressure when the blood vessels relax between heart beats.

Blood Pressure Category

Systolic mm Hg (upper #)

 

Diastolic mm Hg  (lower #)

Normal

Less than 120

and

Less than 80

Prehypertension

120 – 139

or

80 – 89

High Blood Pressure (Hypertension) Stage 1

140 – 159

or

90 – 99

High Blood Pressure (Hypertension) Stage 2

160 or higher

or

100 or higher

Hypertensive Crisis

(Emergency care needed)

Higher than 180

or

Higher than 110

(Source: American Heart Association )

Until 2013, the recommended blood pressure for people with diabetes was 130/80. In 2013, the American Diabetes Association revised their recommendation, stating that systolic pressure should be lower than 140 mm Hg. This year the ADA revised their recommendation for diastolic pressure to lower than 90 mm Hg.

How blood pressure is measured

Your blood pressure rises with each heartbeat and falls when your heart relaxes between beats, and measuring blood pressure is a simple procedure usually done in your doctor’s office. It involves wrapping a cuff snugly around the upper arm. The cuff will be inflated, often by pumping or the push of a button, causing some tightness. As pressure is released from the cuff, the moment that the first pulse of blood is heard gets recorded. This is the systolic pressure. As the air continues to leave the cuff, the moment when the sound stops is also recorded. This is the diastolic pressure.

High blood pressure, also known as hypertension, means blood moves through the vessels with too much force. Hypertension has no symptoms, and is usually diagnosed during a healthcare visit. Anyone with high blood pressure is at risk for heart disease, stroke, eye problems or kidney disease. Diabetes, too, can increase the risk of such ailments, and having diabetes can also make high blood pressure and other heart and circulation problems more likely.

Blood pressure can change from minute to minute with shifts in posture, exercise, stress or sleep, and a single high reading does not necessarily mean a person has high blood pressure. However, if readings stay at 140/90 mm Hg or above (systolic 140 or above OR diastolic 90 or above) over time, a doctor may recommend treatment.

All adults should have their blood pressure checked regularly, and people with diabetes should have blood pressure checked at least every year. The American Diabetes Association says, “You should always have an idea of what your blood pressure is, just as you know your height and weight.”

What to do if you have high blood pressure

If you have high blood pressure, you will need to work with your healthcare provider to find a treatment plan that’s right for you. And doing so is important for your overall health. Dr. Zachary Bloomgarden, clinical professor at Mt. Sinai School of Medicine says, “There is extensive evidence that carefully controlling blood pressure is of tremendous benefit in reducing the development and progression of diabetic nephropathy, cardiac complications and retinopathy.”

Lifestyle changes may help lower blood pressure, but if those aren’t enough, your doctor may discuss medication options with you.

Suggested lifestyle changes include:

Losing weight, exercising, eating a healthy diet, reducing sodium intake, limiting alcohol and caffeine, avoiding tobacco and second-hand smoke, and reducing stress.

The DASH diet (Dietary Approaches to Stop Hypertension) is promoted by the U.S.-based National Heart, Lung, and Blood Institute to prevent and control hypertension. This diet is rich in fruits, vegetables, low fat or nonfat dairy. It also includes grains, especially whole grains; lean meats, fish and poultry; nuts and beans. It is high in fiber and low to moderate in fat. It is a plan that follows U.S. guidelines for sodium content.

Susan Weiner, MS, RDN, CDE*, CDN and 2015 AADE Diabetes Educator of the Year, reminds her patients that a new eating plan doesn’t mean you have to feel restricted.  Instead of focusing on ‘taking away’, she suggests looking at all of the good things – like colorful fruits and vegetables – that you can add to your diet and enjoy. Weiner also says that losing just ten pounds can help lower blood pressure. Be sure to check with your healthcare team before making any changes to your own meal plan.

Jessica Apple is the co-founder and editor in chief of the online diabetes lifestyle magazine A Sweet Life. Her writing has appeared in many publications, including The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review and Tablet Magazine. Apple is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewees, and not of Sanofi US, its employees, agencies or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2015 The DX: The Diabetes Experience

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