Diabetes and High Blood Pressure; a Heart-Breaking Connection

Jul 06, 2022

misc image

Diabetes and High Blood Pressure; a Heart-Breaking Connection

People who have diabetes are twice as likely to have high blood pressure or ‘hypertension’ as those without diabetes. Hypertension occurs when there is an elevated pressure of blood pushing against blood vessel walls. Diabetes increases the risk of developing high blood pressure, at least in part, because excess sugar damages the small blood vessels, causing their walls to stiffen and thereby increasing the pressure of the blood pushing against the walls. Think of the blood vessels as rubber tubes, like hoses, that carry blood from the heart to the rest of the body. When the blood pressure is consistently high, it places strain on the arteries, causing damage which makes them less elastic and more prone to build up plaques. When these plaques form in the arteries in the heart they can become unstable and break off, causing a heart attack.  

Both diabetes and hypertension increase the risk of heart disease, and that risk is additive (meaning the risk is higher if you have both diabetes and hypertension). 

Heart disease is the #1 cause of death in the United States. 

The standard way of measuring blood pressure in the hospital or doctor’s office is via a special device called a ‘sphygmomanometer’ which consists of an arm cuff that can be inflated with air to compress the artery and a meter which can measure pressure. The blood pressure is read as a ratio of two numbers, such as ‘130/80’. The top number is the systolic blood pressure, which measures the pressure of the blood in the arteries as the heart pushes blood out. The bottom number is the diastolic blood pressure, which measures the pressure of the blood in the arteries as the heart is resting and filling back up with blood. As you can imagine, the systolic blood pressure will always be greater than the diastolic blood pressure. 

Treating high blood pressure, either with lifestyle changes like diet and exercise, medications, or a combination of the two, significantly reduces the risk of heart attacks and strokes. Large studies have shown that more intensive blood pressure control reduces the risk of heart disease, therefore the goal blood pressure is often lower for people with diabetes than those without. The most recent American Diabetes Association and World Health Organization guidelines, for example, both recommend considering a target blood pressure of < 130/80 for people with diabetes and hypertension. 

Blood pressure goals vary, though, based on what is safe and practical for each individual. If you have hypertension and diabetes, it is best to talk with your health care provider to figure out the best approach.

4.8