Is Blood Pressure And Diabetes Related?

World Hypertension Day is marked every year on 17 May to make people aware, especially in the low and middle-income countries, of this life-threatening heart disease which is one of the major causes of premature death worldwide. The day also focuses on launching new tools and supportive measures to manage blood pressure.

Hypertension or high blood pressure is often related to diabetes (type 1, type 2 and gestational) by occurring alongside the condition. A large number of studies say that hypertension is one of the major risk factors of diabetes, which can further lead to heart failure, stroke and other cardiovascular conditions. This is the reason why a large number of deaths due to heart diseases occur among diabetics.

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According to a study, in India, the prevalence of diabetes and hypertension is more in middle and old age people across all geographical settings (both rural and urban) and population groups, bringing an important point that household wealth and living standards have no effect on determining the occurrence of these two conditions. [1]

In this article, we will discuss how hypertension is linked to diabetes and other details. Take a look.

The Relationship Between Hypertension And Diabetes

A study published in a PMC journal with the heading “The Comorbidities of Diabetes and Hypertension” have shown that around 75 per cent of adults with diabetes have high blood pressure, while a majority of people with hypertension alone show symptoms of insulin resistance. [2]

Hypertension and diabetes are two chronic and metabolic conditions that are often intertwined. They share common risk factors such as ethnicity, race and lifestyle, and their complications (both macrovascular and microvascular) are also overlapped considerably by common mechanisms.

The macrovascular complications include stroke, heart failure and peripheral heart disease while microvascular complications include neuropathy, nephropathy and retinopathy.

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Cardiovascular disease, which is among the top three leading causes of deaths worldwide, have both hypertension and diabetes as major risk factors.

The relationship between hypertension and diabetes have also caused an enormous economic burden on society, as according to estimated annual medical cost, people spend around 76.6 billion dollars for hypertension-related problems and 174 billion dollars for diabetes care.

Can Hypertension Cause Diabetes?

Many studies support the evidence that diabetes can lead to heart conditions such as hypertension, but studies related to vice versa are quite limited. [3]

This is because hypertension alone cannot cause diabetes, but the reason that has triggered hypertension in people, could increase the risk of diabetes in some.

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The reason could be age, obesity, inflammation, oxidative stress, insulin resistance. [4]

Another study tells that only 50 per cent of hypertensive people have their blood pressure out of control, while the condition is controlled in the remaining 50 per cent. Therefore, the incidence of hypertension in the first 50 per cent is thought to increase due to the aforementioned factors. [5]

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What Are The Normal Blood Pressure Levels?

High blood pressure is measured by two numbers: systolic and diastolic. According to the American Heart Association, the blood pressure range is: [6]

• Normal, when systolic is below 120mmHg and diastolic is below 80mmHg.
• Elevated, when systolic is in between 120-129mmHg and diastolic is under 80mmHg.
• Stage 1 Hypertension, when systolic is in between 130-139mmHg and diastolic is in between 80-89mmHg.
• Stage 2 Hypertension, when systolic is above or equal to 140mmHg and diastolic is above or equal to 90mmHg.

When the systolic reaches higher than 180 and diastolic higher than 120, it means hypertensive crisis. In such a situation, immediate medical attention is required.

Also, readings based on Stage 1 and Stage 2 indicates that a person is at risk of hypertension.

Treatment

1. Lifestyle management

It is the first and prominent method to managing hypertension or preventing its risk in the future. Some of the recommended lifestyle changes include: [7]

• Weight loss, especially for people who fall in the stage 1 hypertension group.
• DASH diet that includes low consumption of sodium, increased intake of potassium, increased fruits and veggies and moderate consumption of alcohol.
• Regular physical activities at least for 30-45 minutes. It is better to consult an expert to give you suggestions on activities depending on your age, severity, medications and other limitations.
• Ways to improve sleeping problems such as sleep apnea, which is also among the main causes of hypertension associated with diabetes. [8]
• Quitting tobacco smoking as it increases the risk of both hypertension and diabetes.

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2. Pharmacologic Antihypertensive Treatment

It is another method of treating hypertensive patients. Using medications to manage hypertension is mainly recommended along with lifestyle changes, in people who already have confirmed high blood pressure.

Treatment of high blood pressure also includes medications to reduce the risk of other heart diseases in patients with diabetes. It includes medications such as:

• ACE inhibitors
• Angiotensin receptor blockers (ARBs)
• Thiazide-like diuretics
• Dihydropyridine calcium channel blockers.

Note: As per the American College of Obstetricians and Gynecologists (ACOG), pregnant women with mild gestational hypertension should not be treated with antihypertensive medications.

To Conclude

Hypertension is a strong risk factor for many macrovascular and microvascular complications of diabetes. Both the conditions often share the same causes and risk factors. Therefore, the best way to keep both chronic conditions at bay is to follow a healthy treatment plan for life that should include lifestyle modifications.

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