The link between diabetes and hypertension

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Hypertension, or high blood pressure, often occurs alongside diabetes mellitus, including type 1, type 2, and gestational diabetes, and studies have shown that they may have connections.

Both forms of metabolic syndrome are hypertension and type 2 diabetes, a disorder that involves obesity and cardiovascular disease.

All hypertension and diabetes may have some similar underlying causes, and share some risk factors. These also contribute to an aggravation of the symptoms of one another. The forms in which these situations are controlled overlap too.

Read on to learn more about the link between high blood pressure and diabetes, how to identify them, and how to reduce both’s negative effects.

Identifying hypertension and diabetes

Some fairly simple tests will show whether a person has diabetes or hypertension.

People can also buy blood glucose testing kits for diabetes and blood pressure monitors for blood pressure, which they can use at home.

Identifying hypertension

A routine health check may reveal high blood pressure.
A routine health check may reveal high blood pressure.

People often refer to hypertension as the “silent killer” because a lot of people don’t know they do.

The American Heart Association (AHA) stresses that signs don’t occur much of the time.

Individuals generally find out when a doctor takes a test of blood pressure they have high blood pressure, or they take one at home.

The reading will give two numbers:

  • The systolic is the top number
  • The diastolic is the bottom number

According to the AHA, the results will be one of the following:

  • Normal: Systolic below 120 and diastolic below 80
  • Elevated: Systolic 120–129 and diastolic under 80
  • Hypertension stage 1: Systolic 130–139 and diastolic 80–89
  • Hypertension stage 2: Systolic 140-plus and diastolic 90 or more
  • Hypertensive crisis: Systolic higher than 180 and diastolic above 120.

A hypertensive crisis means the individual needs to see a doctor right away.

A individual with early stage hypertension is at risk of developing future hypertension.

Habits of lifestyle can help regulate blood pressure, and avoid hypertension and complications. Those shaping lifestyle include:

  • exercise
  • a healthful diet
  • weight control
  • medication

Identifying diabetes

Not everyone with diabetes will experience symptoms, including those with a diagnosis, provided they effectively control their condition.

When there are signs of elevated blood sugar levels that include:

  • excessive thirst
  • frequent need to urinate
  • increased night time urination
  • weakness and tiredness
  • blurred vision

A individual can also note that more infections begin to occur including urinary tract Infections, thrush, and upper respiratory tract. They may also note that it takes longer for wounds and infections to heal.

Tests may indicate that a person has high sugar levels in his or her urine and blood.

Glucose levels after fasting for 8 hours may be:

  • Normal: Less than 100 milligrams per deciliter (mg/dl)
  • Prediabetes: Between 100–125 mg/dl
  • Diabetes: A reading of 126 mg/dl or above

Other tests that a doctor may carry out will show the results in different ways.

There are three kinds of diabetes mellitus, all of which have different causes:

Type 1 diabetes tends to appear during childhood or adolescence, but it can occur later in life. Symptoms can emerge relatively suddenly or over a number of weeks. Type 1 happens when the immune system attacks the cells in the pancreas that produce insulin. There is no way to avoid type 1 diabetes.

Type 2 diabetes can take years to develop, and most people do not notice symptoms. Someone typically finds out that they have prediabetes or type 2 diabetes when they attend a screening or if complications occur, such as neuropathy or kidney problems.

Current recommendations suggest screening for those over 45 years of age or older if they have risk factors like obesity.

This precaution is because someone with an early diagnosis has a greater chance to reverse or delay the condition’s progress and prevent complications before they begin.

One way to do this is by similar lifestyle decisions advised by doctors for hypertension.

Gestational diabetes occurs only during pregnancy but the risk of type 2 diabetes can increase later in life.

Where regular monitoring indicates high levels of blood sugar during pregnancy, a doctor will monitor the condition of the person before delivery. For a few weeks afterwards, they will continue to do so, but usually blood sugar levels fall.

Gestational diabetes can lead to multiple complications, including pre-eclampsia, with extremely high blood pressure being the key symptom of this.

What is the link?

A 2012 study’s authors note that diabetes and hypertension frequently occur together, and can share similar causes.

These include:

Can diabetes cause hypertension?

Diabetes involves high levels of blood sugar.
Diabetes involves high levels of blood sugar.

A diabetes person either doesn’t have enough insulin to absorb glucose, or their insulin doesn’t function well. Insulin is the hormone where the body can absorb and use glucose from food as energy.

Glucose can not reach the cells to provide energy because of insulin problems, and then it accumulates in the blood stream.

When blood containing high levels of glucose passes through the body, it can cause extensive damage to the blood vessels and kidneys, too. Both organs play a key role in keeping blood pressure stable. Blood pressure will increase if they encounter injury, thereby increasing the risk of further harm and complications.

Can hypertension cause diabetes?

A meta-analysis that appeared in the 2015 Journal of the American College of Cardiology (JACC) analyzed data for over 4 million adults. This found that individuals with elevated blood pressure are more likely to develop type 2 diabetes.

This connection may be due to processes in the body, for example inflammation, that affect both conditions

Diabetes and hypertension complications

The combined effects of diabetes and high blood pressure will increase the risk of heart disease, kidney disease and other health issues.

Researchers cited estimates in 2012 indicating that 30 percent of people with type 1 diabetes and 50–80 percent of those with type 2 diabetes in the United States had high blood pressure.

There are three ways in which high blood glucose levels can raise blood pressure:

  • The blood vessels lose their ability to stretch.
  • The fluid in the body increases, especially if diabetes is already affecting the kidneys.
  • Insulin resistance may involve processes that increase the risk of hypertension.

Controlling blood sugar levels and blood pressure can help prevent complications.

Blood pressure monitors and blood glucose monitors are available for purchase online.

Risk factors

Hypertension and type 2 diabetes also share similar risk factors. These include:

  • having excess weight and body fat
  • following an unhealthful diet
  • having an inactive lifestyle
  • stress and poor sleep habits
  • smoking tobacco
  • older age
  • having low levels of vitamin D

Getting a hypertension family history increases the risk of hypertension while a diabetes family history increases the risk of diabetes, particularly type 2.

Hypertension tends to increase the risk of type 2 diabetes, and the risk of hypertension decreases with type 2 diabetes.

Having one or both conditions, often raises the possibility of various complications, including:

  • heart attack or stroke
  • decreased kidney function, progressing to dialysis
  • problems with the blood vessels in the eyes, leading to vision loss
  • peripheral vascular disease

Other factors that increase the risk of hypertension include:

  • having a high fat or high sodium diet
  • high alcohol consumption
  • low levels of potassium
  • other chronic conditions, such as sleep apnea, kidney disease, or inflammatory arthritis

Making healthy lifestyle decisions from an early age will help avoid hypertension and type 2 diabetes. People with diabetes can benefit by regulating their blood sugar levels to reduce the risk of high blood pressure and cardiovascular disease.

Prevention

Lifestyle factors are crucial for managing both blood glucose and blood pressure.

A healthy weight

Losing just a little will help to reduce the risk of both high blood pressure and diabetes for those with extra weight.

The National Heart, Lung, and Blood Institute (NHLBI) points out for people with excess weight that if a person loses 3–5 percent of their weight, they will increase their blood pressure readings.

Likewise, the Centers for Disease Control and Prevention (CDC) states that losing 5–7 percent of body weight will help prevent prediabetes from becoming diabetes. It would be a 10–14 pound loss for someone weighing 200 pounds.

Activity

Regular exercise can lower blood pressure and help regulate blood sugar, and many other health benefits are provided.

Current recommendations advise us to perform aerobic exercise of at least 150 minutes of moderate intensity per week, or 75 minutes of intense intensity exercise. Walking and swimming include mild exercise.

Many that have not been involved for a while will get advice from their doctor on a sensible workout schedule.

Healthful dietary choices

People with diabetes and hypertension should talk to their doctor about a dietary plan.

This will usually include:

  • eating plenty of fresh fruits and vegetables
  • focusing on high-fiber foods, including whole grains
  • limiting the amount of added salt and sugar
  • avoiding or limiting unhealthful fats, such as trans fats and animal fats

Doctors often recommend the DASH diet for managing blood sugar and overall wellbeing.

Learn more here about what to eat on the DASH diet.

A diabetes person may need to monitor their carbohydrate intake and check their blood glucose levels to ensure they meet the goals set by their treatment plan.

Limiting alcohol consumption

Sparkling water is a healthful alternative to alcohol.
Sparkling water is a healthful alternative to alcohol.

High consumption of alcohol can increase the risk of:

A limit of one alcoholic drink per day is recommended for women by the American Diabetes Association (ADA), and two alcoholic drinks a day for men.

One drink will be a 12 ounce bottle, a 5 ounce glass of wine, or a 1.5 ounce alcohol serving such as whiskey, gin, or vodka.

Mixers can incorporate carbohydrates and calories, as well. Sparkling water is a safer alternative compared with sweetened soda.

An person may want to speak to their doctor about how much alcohol they’re safe to drink.

Not smoking

There is evidence that smoking tobacco can raise both the risk of high blood pressure and of diabetes.

Diabetes smokers are at a higher risk for severe complications including:

  • heart or kidney disease
  • retinopathy, an eye disease that may lead to blindness
  • poor blood flow, making infection and the risk of amputation more likely in the legs and feet
  • peripheral neuropathy, which can cause nerve pain in the arms and legs

An person who has or is at risk of diabetes, high blood pressure, or both can talk to their doctor about how to quit smoking.

Treatment with medication

A doctor can prescribe medications as follows in addition to lifestyle measures:

Type 1 diabetes: the person will need insulin, and probably blood pressure and other medications depending on any complications they may have.

Type 2 diabetes: Some people may need to use insulin, or a doctor can prescribe metformin or other non-insulin drugs to help lower blood sugar levels. They may also require high blood pressure medicine, or other complications.

Current recommendations also suggest using one of the following if a person with type 2 diabetes has a high risk of cardiovascular atherosclerotic disease, kidney disease due to diabetes or both.

  • sodium-glucose cotransporter 2 inhibitors (SGLT2)
  • glucagon-like peptide 1 (GLP-1) receptor agonists

These drugs offer protection to the heart and kidneys by helping control blood sugar levels.

High blood pressure: Medications include ACE inhibitors, beta blockers, and diuretics

Outlook

Hypertension and diabetes sometimes happen together, and certain risk factors and causes tend to be related.

Adjustments to the lifestyle will help regulate blood pressure and blood sugar levels, but most people will continue to adopt a lifetime treatment program.

A doctor should formulate a treatment plan for the patient, who will keep in contact for their healthcare team and check in with a healthcare provider if they feel they need to change their treatment.

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