Preventing High Blood Pressure With Diabetes
There are many lifestyle changes that can lower your blood pressure. Nearly all are dietary, but daily exercise is also recommended. Most doctors advise walking briskly for 30 to 40 minutes every day, but any aerobic activity can make your heart healthier.
The recommends a minimum of either:
- 150 minutes per week of moderate-intensity exercise
- 75 minutes per week of vigorous exercise
- a combination of moderate and vigorous activity each week
In addition to lowering blood pressure, physical activity can strengthen the heart muscle. It may also reduce arterial stiffness. This happens as people age, but is often accelerated by type 2 diabetes. Exercise can also help you gain better control of your blood sugar levels.
Work directly with your doctor to develop an exercise plan. This is especially important if you:
- havent exercised before
- are trying to work up to something more strenuous
- are having trouble meeting your goals
Start with five minutes of brisk walking each day and increase it over time. Take the stairs instead of the elevator, or park your car farther from the store entrance.
You may be familiar with the need for improved eating habits, such as limiting sugar in your diet. But heart-healthy eating also means limiting:
- salt
- high-fat meats
- whole-fat dairy products
How Does Diabetic Kidney Disease Develop And Progress
A raised blood sugar level that occurs in people with diabetes can cause a rise in the level of some chemicals within the kidney. These chemicals tend to make the glomeruli more âleakyâ which then allows albumin to leak into the urine.
In addition, the raised blood glucose level may cause some proteins in the glomeruli to link together. These âcross-linkedâ proteins can trigger a localised scarring process. This scarring process in the glomeruli is called glomerulosclerosis. It usually takes several years for glomerulosclerosis to develop and it only happens in some people with diabetes.
As the condition becomes worse, scarred tissue gradually replaces healthy kidney tissue. As a result, the kidneys become less and less able to do their job of filtering the blood. This gradual âfailingâ of the kidneys may gradually progress to what is known as end-stage kidney failure.
- Microalbuminuria is usually the first sign that diabetic kidney disease has developed. Over months or years, microalbuminuria may go away , persist at about the same level, or progress to proteinuria.
- Proteinuria is irreversible. If you develop proteinuria it usually marks the beginning of a gradual decline in kidney function towards end-stage kidney failure at some time in the future.
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Can Hypertension Cause Diabetes
A meta-analysis appearing in the Journal of the American College of Cardiology in 2015 looked at data for more than 4 million adults. It concluded that people with high blood pressure have a higher risk of developing type 2 diabetes.
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The combined impact of diabetes and high blood pressure can increase the risk of cardiovascular disease, kidney disease, and other health problems.
In 2012, researchers quoted figures suggesting that of people with type 1 diabetes and 5080% of those with type 2 diabetes have high blood pressure in the United States.
There are three ways in which high glucose levels in the blood can increase 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.
Hypertension and type 2 diabetes also share similar risk factors. These include:
- having excess weight and body fat
- following an unhealthful diet
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
Lifestyle factors are crucial for managing both blood glucose and blood pressure.
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Can High Blood Pressure Cause Extreme Fatigue And Some Chest Pains
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Individualization Of Treatment Targets
Patients and clinicians should engage in a shared decision-making process to determine individual blood pressure targets, with the acknowledgment that the benefits and risks of intensive blood pressure targets are uncertain and may vary across patients. Following the ADA approach to the management of hyperglycemia, factors that influence treatment targets may include risks of treatment , life expectancy, comorbidities including vascular complications, patient attitude and expected treatment efforts, and resources and support system . Specific factors to consider are the absolute risk of cardiovascular events , risk of progressive kidney disease as reflected by albuminuria, adverse effects, age, and overall treatment burden. Patients who have higher risk of cardiovascular events or albuminuria and who can attain intensive blood pressure control relatively easily and without substantial adverse effects may be best suited to intensive blood pressure control. In contrast, patients with conditions more common in older adults, such as functional limitations, polypharmacy, and multimorbidity, may be best suited to less intensive blood pressure control.
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Pathophysiology: Converging Pathways In Coexisting Dm And Htn
DM and HTN share several pathophysiologic mechanisms including: inappropriate activation of the renin angiotensin aldosterone system , oxidative stress secondary to excessive production of reactive oxygen species , inflammation, impaired insulin-mediated vasodilatation, increased sympathetic nervous system activation, dysfunctional innate and adaptive immune responses and abnormal renal handling of sodium . Obesity and increased visceral adiposity are key pathogenic factors behind the coexistence of both DM and HTN . Chronic low-grade inflammation and oxidative stress in the adipose tissue lead to increased production of angiotensinogen and angiotensin II which consequent tissue RAAS activation . Further, overexpression of AGT in the white adipose tissue results in elevated BP . Hence, AGT and Ang II have local as well as systemic effects on BP regulation . Ang II exerts many of its detrimental effects via activation of the Ang II type 1 receptor . The activation of AT1R in non-adrenal tissues results in multiple intracellular events, including production of ROS, reduced insulin metabolic signaling, and proliferative and inflammatory vascular responses resulting in endothelial dysfunction, insulin resistance and HTN . Thus, there is often an activated RAAS in coexistent DM and HTN.
Diabetes And High Blood Pressure Headaches
The combined effect of diabetes and excessive blood stress can boom the hazard of cardiovascular sickness, kidney sickness, and different fitness issues.
In 2012, researchers quoted figures suggesting that 30percentTrusted Source of human beings with kind one diabetes and 5080% of those with kind two diabetes have excessive blood stress withinside the United States.
There are three methods wherein excessive glucose ranges withinside the blood can boom blood stress:
The blood vessels lose their cap potential to stretch.The fluid withinside the frame will increase, in particular, if diabetes is already affecting the kidneys.Insulin resistance might also contain tactics that boost the high blood pressure hazard.Controlling blood sugar ranges and blood stress can assist save you headaches.
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Is A Pressure Of 50 In The Eyes Excessive
Eye pressures of 21-30 mmHg linked with glaucoma often cause damage over time. However, an IOP of 40-50 mmHg may result in retinal vascular occlusion, a potentially fatal syndrome in which the blood vessels that supply the retina become clogged.
I was just diagnosed with high blood sugar for the first time in my life. Im 48 years old. Diabetes runs in my family. I had no idea Id acquire it, but my doctor stated it was at an all-time high of 275+ and that I needed medication. I turned down the doctors offer and asked for a month to get it under control and rechecked. I got the pills here and began using them in conjunction with my diet. My doctor gave me the tester so I could monitor my blood level at home. After a week of taking it once in the morning before breakfast and once in the afternoon before lunch. Id check it in the evening. Surprisingly, it was at 102,105, and once at 98. And depending on what and how much I eat, it would rise to 120-128 after supper. A month later, I returned for my checkup, and everything was OK. Doctors say that if I stick to my healthy diet and exercise routine, Ill be OK. It actually works!! Ill be getting another bottle shortly.
What Is The Recommended Blood Pressure Range For People With Diabetes
Its important to keep your blood pressure within a healthy range. This reduces your chances of your body developing further health complications.
Blood pressure should be below 140/80mmHg for people with diabetes or below 130/80mmHg if you have kidney or eye disease or any condition that affects blood vessels and blood supply to the brain. But it is important to speak to your healthcare team about your individual target.
Whilst you may not have any symptoms of high blood pressure, it can be harmful to your health if left untreated. This is due to the increased pressure placed on your heart, eyes, kidneys and other organs.
As weve said previously, heart attack or stroke are some of the conditions your body becomes more vulnerable to with high blood pressure. Other conditions you become more at risk of include:
- Cardiovascular dementia
- Heart failure
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Can High Blood Pressure Cause Diabetes
The relationship between diabetes and high blood pressure can go in both directions. A study in Korea showed that individuals with hypertension are more likely to develop diabetes, and that managing blood pressure in susceptible individuals can reduce the risk of diabetes. However, for this to work, you have to be able to get your blood pressure down to normal ranges.
The study suggests that blood sugar should be checked regularly in people with hypertension, so make sure to talk to your doctor about getting screened regularly.
Treatment Of Hypertension In Adults With Diabetes Mellitus
As we mentioned before, it is obvious that many patients with hypertension would need three or even more drugs to achieve the target of < 130/80 mmHg of blood pressure. The goal of that regimen is not to produce high blood pressure complications, and most patients find the drug option is easy and affordable.
As a first-line agent, Angiotensin-converting enzyme inhibitors are used in patients with diabetes, and Angiotensin II Receptor Blockers are considered as first-line therapy for the prevention and slow down the progression of nephropathy.
Other strategies include using diuretic and -blockers.
Lower effectiveness of dihydropyridine calcium channel blockers in reducing the chances of cardiac events including heart failure, and the progression of kidney diseases compared with ACE inhibitors, ARBs, -blockers, or diuretics, these drugs are recommended as a second-line option.
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That means when your result of effectively controlling blood pressure following the use of other drug combinations fail or not suited or tolerated youre your doctor may try the other medicines or may consider additional agents to control your blood pressure.
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Other classes, including -blockers, can be used under specific indications, or some other that have failed to control blood pressure or have some side effects that are not acceptable.
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Q Are Diabetics At Risk Of Developing High Blood Pressure
A. Although there is not a direct connection for diabetics to develop hypertension, they are at a higher risk of it. So if a person with high sugar levels is diagnosed with high blood pressure as well, she should carefully manage it by making certain lifestyle changes and altering medication as per the advice of the doctor. Those with high blood pressure should be careful about their intake of salt and reduce as much as possible.
How To Identify Diabetes Or High Blood Pressure
Each of these two diseases is easy to identify using simple tests.
Diabetes
To identify diabetes, people use blood glucose tests and a1c testing.
High blood pressure
For high blood pressure, most of the times people are not aware that they have it, and they usually find out that they have high blood pressure after a random blood pressure reading provided by the doctor.
If you experience high blood pressure, it means that your heart pumping blood in higher pressure, so blood vessels are in too much force which over time tires heart muscle.
Very often, people with high blood pressure will not have any signs or symptoms.
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A device known as sphygmomanometer is used to measure blood pressure. It can be done by a health provider, doctor, or at home.
Blood pressure is recorded as systolic, maximum pressure during a heartbeat and diastolic, lowest pressure between heartbeats.
Medical guidelines show that normal blood pressure is less than 120/80mm Hg, and you have hypertension if blood pressure is higher than 130/80.
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Just one high-pressure reading does not mean that you have hypertension since high blood pressure is connected to your age, emotions, medication you are taking and heart conditions.
Diabetes
Early detection of diabetes can prevent limb amputation, stroke, kidney failure, vision loss, heart disease or stroke.
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How Is Hypertension Diagnosed
Your healthcare provider will ask about your symptoms and the medicines you take. He or she will also ask if you have a family history of high BP and about any health conditions you have. He or she will also check your BP. If your BP is high, you will need to have it confirmed at another visit. Your provider will also check your weight and examine your heart, lungs, and eyes. You may need any of the following tests:
- An ambulatory blood pressure monitor is a device that you wear. ABPM measures your BP while you do your regular daily activities. It records your blood pressure every 15 to 30 minutes during the day. It also records your BP every 15 minutes to 1 hour at night. The recorded BP’s help your healthcare provider know if you have hypertension not seen at your appointment.
- Blood tests may help healthcare providers find the cause of your hypertension. Blood tests can also help find other health problems caused by hypertension.
- Urine tests will be done to check your kidney function. Kidney problems can increase your risk for hypertension.
Diabetes Medications With Antihypertensive Effects
Several anti-diabetic medications possess modest antihypertensive properties. These should be kept in mind especially in patients concurrently receiving antihypertensive drugs who may experience hypotensive symptoms if caution is not exercised. On the other hand, several of these drugs provide cardiovascular protection, likely in part from their antihypertensive effects that make them attractive options for patients at increased cardiovascular risk. Anti-diabetic medications with these properties include thiazolidinediones, dipeptidyl diphosphatase inhibitors, glucagon-like peptide 1 receptor agonists, and sodium glucose cotransporter 2 inhibitors. Of these classes, GLP-1 receptor agonists appear to exert the largest effect on blood pressure .
In a metanalysis of 16 randomized control trials comparing the GLP-1 agonists exenatide and liraglutide to placebo as well as other antihyperglycemic agents, BP reduction was seen. Against placebo, exenatide lowered systolic BP by approximately 6 mm Hg. Similarly, a mean reduction of about 5 mm Hg in systolic BP was seen with liraglutide versus placebo . A randomized control trial studying the hemodynamic effects of dulaglutide also showed a reduction in systolic BP regardless of baseline readings . The other classes of anti-hyperglycemic medications have shown reductions in systolic BP of less than 5 mm Hg .
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A Little Something About Blood Pressure
Have you seen water run through a pipe? As the water runs through the pipe, it applies some force against the walls of the pipe. This force is the pressure of water. Just like that, the blood flowing within your blood vessels exerts some pressure on these pipe-like vessels. This pressure is called blood pressure.
Doctors measure blood pressure using an instrument that resembles a cuff. Normal values of blood pressure are 120/80 mmHg. The first number here is the systolic pressure, which measures the pressure in your arteries when your heart fills them up with blood. The bottom number is the diastolic pressure and it measures the pressure in your arteries when your heart itself fills with blood in between heart beats.
Data Collection Instrument And Procedure
We used pre-tested interviewer-administered questionnaire to collect the data. The questionnaire were adapted from relevant literatures19,20,24,25,28–31 and reviewed by clinicians in diabetes care to ensure its content validity. It was initially prepared in English by language experts, and translated into the local language and then retranslated to English by another expert to ensure its consistency. Data were collected by 4 nurses and one supervisor . Type 2 DM patients were identified by checking the physician diagnosis on their chart/medical record. A person is considered as having T2DM when he/she has a FBG of 126 mg/dl, HbA1C 6.5%, or on medication for T2DM.32,33
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Overlapping Characteristics Of Diabetes And High Blood Pressure
A 2012 study in China focused its research on how obesity, inflammation, oxidative stress, and insulin resistance in patients with type 2 diabetes may influence blood pressure levels.
The study suggests that both conditions diabetes and hypertension result from the onset of low-grade inflammation and that both should be considered as chronic inflammatory diseases.
It is now realized that insulin resistance, which predicts type 2 diabetes, also has a role in the development of hypertension, explains the study. Indeed, hypertension and diabetes substantially share common pathways such as obesity, inflammation, oxidative stress, insulin resistance, and mental stress.
In reality, diabetes and hypertension are found in the same individual more often than would occur by chance, adds the study. The researchers concluded that both conditions are often the result of genetic or environmental factors: diet, weight, tobacco use, stress, and activity level.
Exercise can play a major role in the development and treatment of both conditions.
In the Finnish Diabetes Prevention Study, subjects with a change in moderate-to-vigorous leisure-time physical activity were 49% to 65% less likely to develop diabetes, explains the report.
Then, in the Coronary Artery Risk Development in Young Adults study with over 15 years of follow-up, patients engaging in regular exercise saw a 17 percent reduction in their risk of high blood pressure.