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High Blood Pressure and Diabetes

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High Blood Presure and Diabetes

By Nina Nazor

What is the relationship between high blood pressure and diabetes?


Hypertension affects 20-60% of people with diabetes and is associated with accelerated progression of eye disease, kidney disease and heart disease.


In type 2 diabetes, hypertension is often present as part of the metabolic syndrome, which is comprised of obesity, hypertension and high blood levels of insulin, triglycerides, bad cholesterol and glucose. In type 1 diabetes, hypertension may reflect the onset of diabetic nephropathy.


The good news is that high blood pressure can be controlled almost by the same means as high blood glucose levels: healthy diet, exercise, stress management and medications.


In the U.K. Prospective Diabetes Study (UKPDS) study, each 10-mmHg decrease in mean systolic blood pressure was associated with reductions in risk of 12% for any complication related to diabetes.


What is blood pressure?

Blood pressure is the force of the blood against the walls of the arteries, caused by the heart pumping blood in order to reach every part of your body.


Blood pressure is always given as two numbers, the systolic and diastolic pressures:


1. When the heart beats, it pumps out blood into the arteries. This is called systolic pressure and is the high number of a blood pressure reading.


2. When the heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure and is the lower number of a blood pressure reading.

Blood pressure is different throughout the day. It is lowest when we sleep and rises when we get up. It also can rise when we are excited, nervous, or physically active.


What is normal blood pressure?

A reading below 120/80 is considered normal. If you have diabetes, your target blood pressure shall be less or equal to 120/80.


Remember that a good diabetes control means achieving near normal levels of blood glucose, cholesterol and also blood pressure.

What is high blood pressure?

Traditionally, blood pressure of 140/90 or higher is considered high blood pressure or hypertension. However, blood pressure of 130/80 or higher is considered high blood pressure in persons with diabetes and chronic kidney disease.


If you are being treated for high blood pressure, you still have high blood pressure even if you have repeated readings in the normal range. Precisely that is the objective of the treatment of hypertension: to achieve normal levels.

What is the treatment of high blood pressure?


Following a healthy lifestyle and taking the right medications is the key of hypertension control.


Lifestyle changes for blood pressure control


These include the following:


Maintain a healthy weight

Be physically active

Follow a healthy eating plan that emphasizes fruits vegetables, and lowfat dairy foods

Eat foods with less salt and sodium

Drink in moderation

Quit smoking

Control your stress levels

Sleep 7-8 hours a day


Medications for blood pressure control


The following are the medications most used for high blood pressure control. In many cases, physicians use two or more drugs combined to take advantage of different ways of action.


Diuretics. They help the body get ride of excess watter. In this case, the more water in the body the higher the volume of blood and the stronger the heart has to pump to manage all that volume, causing the pressure of the blood to raise.


Beta-blockers. These medications reduce nerve impulses to the heart causing the heart to beat slower and with less force. Blood pressure is reduced and the heart works less hard.


ACE inhibitors. These medications inhibit an enzime called angiotensin-converting enzyme (ACE) and prevent the production of a hormone called angiotensin II, which usually causes blood vessels to contract. ACE inhibitors cause the vessels to relax and blood pressure drops. Latest research states that ACE inhibitors may be considered the drugs of first choice for people with diabetes, hypertension and proteinuria, since it is believed that they protect the kindneys.


Angiotensin antagonists. They protect blood vessels from the effect of the hormone angiotensin II. As a result, the blood vessels become wider and relaxed and blood pressure drops. They have a similar effect as ACE inhibitors but through a differeny path.


Calcium channel blockers. They keep calcium from entering the cells of the heart and blood vessels, causing blood vessels to relax and blood pressure to drop.


Alpha-blockers. These medications reduce nerve impulses to blood vessels, allowing blood to flow more easily, causing the blood pressure to drop.


Alpha-beta-blockers. They a mix of alpha-blockers, reducing nerve impulses to blood vessels, but also slowing the heartbeat, as beta-blockers do.This causes less blood pumped through the vessels and blood pressure drops.


Nervous system inhibitors. They relax blood vessels by controlling nerve impulses. In a similar way as alpha and beta blockers, cause blood vessels to relax and the blood pressure to drop.


Vasodilators. These medications make blood vessels wider by relaxing the muscle in the vessel walls, causing the blood pressure to drop.


What are the consequences of high blood pressure?

High blood pressure is called "the silent killer" because it usually has no symptoms. Some people may not find out they have it until they have trouble with their heart, brain, eyes or kidneys.


When high blood pressure is not found and treated, it can cause:


·        Increase of the size of the heart, which may lead to heart failure.

·        Development of aneurysms (small bulgs) in blood vessels and arteries.

·        Kidney and retina blood vessels can be affected not only by high blood pressure but also by high glucose levels, causing diabetic retinopathy and neprhopathy.

·        Blood vessels in the eyes can burst or bleed, which may cause blindness.

·        Hardening of the arteries of the heart, brain, kidneys, and legs can cause heart attacks, stroke, kidney failure or amputation.

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