High Blood Pressure in Diabetes

Elevated blood pressure (hypertension) is a common problem in people with diabetes.

Along with elevated cholesterol and obesity, it is one of the major risk factors for heart disease.

Although there is some controversy regarding blood pressure(BP) goals in people with DM, the American Diabetes Association (ADA) recommended a goal BP of <130/80.

The top number is the systolic BP. This is the pressure exerted on the blood vessel walls when your heart is beating.

The bottom number is the diastolic BP. This is the pressure when your heart is relaxed.

The BP goal is lower in diabetics due to the high “background” risk of heart disease in diabetics. This risk is further increased once BP levels rise.

Make sure that your pressure is measured correctly.

You should be seated with your arm at heart level when the measurement is obtained.

Ideally, you should sit for five minutes before a measurement is obtained.

If you are overweight, ask for the large cuff. A regular-sized cuff will not be accurate.

Falsely elevated measurements may be caused by anxiety, “white coat hypertension” and/or improper technique.

It is thus important to confirm elevated measurements with a second office-based reading.

If the average systolic value is 130-139 mmHg, or if the average diastolic value is 80-89 mmHg, the ADA recommends a three month trial of “lifestyle therapy”.

This typically includes a recommendation for weight loss (5-7% if overweight), exercise (30 minutes per day once cleared by cardiologist), salt restriction (<1500-2000 mg daily), and alcohol restriction (<2 servings per day in men and <1 serving per day in women).

This is otherwise known as the “Dash” diet: Dietary Approaches to Stop Hypertension.