Studies have found that at least 1 in 3 patients with type 1 diabetes also have hypertension. When hypertension and diabetes co-exist, the effects of one disease tend to make the other worse. This makes for a deadly combination. Diabetes does three things that may increase blood pressure:

• Decreasing the blood vessels' ability to stretch
• Increasing the amount of fluid in the body
• Changing the way the body manages insulin

Hypertension and diabetes generally coexist because they share similar risk factors, including being overweight, following an unhealthy diet, and living an inactive lifestyle. Patients should report any consistent blood pressure readings of 140/90 or higher to their doctors, as these may result in complications

RISK FACTORS

The combination of hypertension and diabetes can be lethal, and together they can increase the risk of a heart attack or stroke. Having both conditions also increases the risk of kidney disease and problems the blood vessels of the eyes, which could lead to blindness.Smoking increases the risk of both diabetes and hypertension Uncontrolled diabetes is not the only risk factor for hypertension. The chances of having a heart attack or stroke are further multiplied if other risk factors exist, in addition to diabetes. These include:

• Having a family history of heart disease
• Stress
• Having a high fat or high sodium diet
• Not being active
• Advanced age
• Being overweight
• Smoking
• Overconsumption of alcohol
• Having another chronic condition, such as sleep apnea, kidney disease or inflammatory arthritis
• Low levels of potassium or vitamin D

People with diabetes should try to minimize these risks as far as possible, for example, by choosing a healthy lifestyle.

PREVENTION

Lifestyle factors are the best way to lower the risk of high blood pressure and to maintain normal levels. There is a wide body of evidence, which demonstrates that controlling blood pressure in people with diabetes reduces the risk of complications. A study in the United Kingdom (U.K.) followed 1,148 people with diabetes for several years. The participants whose blood pressure was well-controlled had a significantly reduced risk of dying from complications related to diabetes, hypertension, or both.

WEIGHT LOSS

Losing even a small amount of weight can make a difference in bringing down blood pressure. The National Heart Lung and Blood Institute (NHLBI) points out that losing 10 pounds in weight can reduce blood pressure.

PHYSICAL ACTIVITY

People who live with both hypertension and diabetes should try to be active at least five days a week for at least 30 minutes per day. Regular activity lowers blood pressure and offers many other health benefits.

HEALTHY DIET

People with diabetes should already be closely monitoring their diet in order to maintain blood sugar. They should also limit the amount of salt in cooking and avoid adding salt to food to help maintain blood pressure.Reducing alcohol consumption can help control hypertension. The intake of too much alcohol leads to increased blood pressure. Reducing heavy drinking to the recommended amounts of alcohol decreases the risk of hypertension.

NO SMOKING

Nicotine in cigarettes raises blood pressure and heart rate. It also adds stress to the heart and increases the risk of heart attack and stroke. Smokers with diabetes have a higher risk of serious complications, including:

• Heart or kidney disease
• Peripheral neuropathy, or nerve pain in arms and legs
• Retinopathy, an eye disease that may lead to blindness
• Poor blood flow in the legs and feet, which may lead to infection and even amputation

TREATMENT AND MEDICATION

Blood pressure medication is recommended if blood pressure consistently remains above 140/90 for people with diabetes, despite lifestyle changes. Most people with hypertension will need to keep taking blood pressure medication for the rest of their lives. The only exception would be for someone who blood pressure has been well controlled for significant period of time due to major lifestyle changes, such as losing a lot of weight, being consistently active or after a significant reduction in alcohol consumption.

PREVENTING HIGH BLOOD PRESSURE WITH DIABETES

There are many lifestyle changes that can lower your blood pressure. Nearly all are dietary, but daily exercise is also recommended. Most doctors advise walking briskly for 30 to 40 minutes every day, but any aerobic activity can make your heart healthier. In addition to lowering blood pressure, physical activity can strengthen the heart muscle. It may also reduce arterial stiffness. This happens as people age, but is often accelerated by type 2 diabetes. Exercise can also help you gain better control of your blood sugar levels. Work directly with your doctor to develop an exercise plan.
This is especially important if you:

• Haven’t exercised before
• Are having trouble meeting your goals
• Are trying to work up to something more strenuous

Start with five minutes of brisk walking each day and increase it over time. Take the stairs instead of the elevator, or park your car farther from the store entrance.

TREATNG HIGH BLOOD PRESSURE WITH DIABETES

While some people can improve their type 2 diabetes and high blood pressure with lifestyle changes, most require medication. Depending on their overall health, some people may need more than one medication to help manage their blood pressure. Most high blood pressure medications fall into one of these categories:

• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers
• Beta-blockers
• Angiotensin-converting enzyme (ACE) inhibitors
• Diuretics

Some medications produce side effects, so keep track of how you feel. Be sure to discuss any other drugs you’re taking with your doctor.