Diabetes and high blood pressure

High blood pressure (BP) or hypertension is common in people with diabetes.

In most people with type 1 (insulin dependent) diabetes, high blood pressure develops as often as it does in people without diabetes.
In some people with type 1 (insulin dependent) diabetes, blood pressure may rise if the kidneys have become damaged by poor glucose control.
High blood pressure is much more common in type 2 (non-insulin dependent) diabetes. It affects around half of these people and may even be present before the diabetes has been diagnosed

In all people with diabetes, if blood pressure is not controlled properly, the chances of having a heart attack, a stroke or problems with eyes or kidney damage are greater.

What are the symptoms of high BP?

There are no symptoms that can warn of high BP. Untreated high BP can do damage without you knowing it; this is why BP must be checked regularly when you attend the Diabetes Clinic.

At what level is BP considered to be high?

Your blood pressure should be checked at each visit to the Diabetes Clinic. As some people become anxious when attending the hospital, often the BP will be a little higher at the hospital than with your GP. You may be asked to have your BP checked more often than this if yours has been ‘borderline,’ before you are started on any treatment.

For most patients BP should be:

A top figure of 140 or less
A bottom figure of 80 or less

Some people need to aim for a lower figure than this, especially if they have complications of diabetes. For others, especially the over-75’s with diabetes, a higher BP level may be tolerated. Your GP or Hospital Doctor will advise you individually about what levels to aim for.

What should you do if your BP is high?

Watch your weight
Reduce your salt intake to a minimum
Take regular moderate exercise e.g. 20 minutes brisk walking on 3 days per week to start with and build this up gradually
Reduce your alcohol intake; ask your doctor or nurse for advice
Stop smoking. Although smoking does not cause high BP, it can make strokes, heart attacks, kidney and eye damage more likely.
You may be prescribed blood pressure tablets. Make sure that you take these regularly. If they cause side effects, let your doctor know so that an alternative tablet can be used.

What else should you know?

Keeping your BP below 140/80 cuts down the chances of death from long-term complications of diabetes by a third
Good BP control can significantly reduce your risk of serious eye damage
Good BP control protects your kidney function