An estimated 37 million people in the US have diabetes (almost three times this number have prediabetes), making it one of the fastest-growing epidemics in history and a major public health concern.1 While type 1 and type 2 diabetes wreak havoc on your metabolism and hormones, it can also lead to other conditions that negatively impact your health, like nerve damage, vision impairment, kidney disease, and arguably the most dangerous, high blood pressure.2
You are twice as likely to develop high blood pressure if you live with diabetes, and 74% of people currently diagnosed with diabetes suffer from high blood pressure.3,4
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Can Diabetes Actually Cause High Blood Pressure?
Diabetes is a condition that occurs when your blood glucose levels (or blood sugar) get too high. While glucose helps provide our body with energy, it’s not meant to stay in our blood vessels at high concentrations for long periods. Normally, when our blood sugar rises, our pancreas pumps out insulin, shuttling the glucose molecules out of the blood and into cells where they can be utilized.
You can think of insulin as the key that unlocks the cells and lets glucose inside. In people living with diabetes, the pancreas doesn’t produce enough insulin, or the body can’t use insulin properly. Hence, glucose molecules aren’t able to enter into cells as they typically would. Instead, they stay in the blood, which can damage blood vessel walls.
High blood sugar can reduce the elasticity of arteries, impairing their ability to relax and causing vascular stiffness, which leads to high blood pressure (also known as hypertension).4
Our bodies have a special system responsible for regulating blood pressure called the renin-angiotensin-aldosterone system (RAAS). Angiotensin II and aldosterone work together to raise blood pressure by causing your blood vessels to constrict and also causing your body to retain more water. Obesity and insulin resistance are associated with dysfunction of the RAAS and higher aldosterone levels. Both of which increase the risk of high blood pressure.4
Increased blood sugar caused by diabetes affects our organs and blood vessels, and the kidneys are particularly vulnerable. The kidneys are made up of millions of tiny filters called nephrons. Over time, elevated blood sugar levels can cause inflammation, damaging the nephrons and decreasing their ability to filter the blood. The deterioration of kidney function is called diabetic nephropathy and can ultimately lead to chronic kidney disease. Diabetic nephropathy can also cause hypertension.5
Risk Factors of Diabetes and Hypertension
Below are common risk factors for both diabetes and hypertension:
- Overweight & obesity
- High blood sugar (hyperglycemia)
- Insulin resistance
- Sedentary lifestyle
- Chronic inflammation
101 of High Blood Pressure
Blood pressure is the force of the blood pushing against your arterial walls. It’s perfectly normal for your blood pressure to rise and fall throughout the day, but if it continually stays elevated, it can cause many problems.
Hypertension may be common (affecting an estimated 48% of adults), but it’s a very serious condition. It can cause damage to organs like the heart, kidneys, and brain and may also lead to heart disease and stroke, two of the leading causes of death in the US.6,7 The signs and symptoms of high blood pressure can be subtle, so it’s a good idea to measure it regularly with your healthcare provider.
Diabetes Blood Pressure Ranges Chart
Blood pressure is measured using two numbers: the first is called systolic blood pressure, and the second is called diastolic blood pressure. Systolic is the pressure in your arteries when your heart beats, and diastolic pressure is the pressure in the arteries when the heart rests between beats. A normal blood pressure is considered to be less than 120/80 mmHg.
Normal Blood Pressure - Less than 120/80 mmHg
Pre-Hypertension - 120/80 to 139/89 mmHg
Hypertension - Greater than 140/90 mmHg
Potential Complications of Diabetes and High Blood Pressure
Diabetes and high blood pressure can be the perfect storm for your health. Not only does diabetes contribute to the onset of hypertension, but it can also worsen the condition.4
Diabetes and high blood pressure can lead to increased risk for serious and even fatal complications:
- Heart Disease - High blood sugar from diabetes and increased arterial tension from high blood pressure injure your blood vessels. This results in your vessels becoming less elastic and stiffer and can lead to heart disease and heart failure.8
- Chronic Kidney Disease - Diabetes can impact the kidneys' tiny filters (nephrons), a condition called diabetic nephropathy. The inflammation and fibrosis caused by diabetes are exacerbated by hypertension, leading to chronic kidney disease.4,5
- Peripheral Artery Disease (PAD) - This condition occurs when arteries in your arms and legs narrow, reducing blood flow to your extremities. It can cause severe leg pain and even make it difficult to walk. PAD also increases your risk of heart attack and stroke.9
- Neuropathy - Uncontrolled diabetes can cause nerve damage. Nerves in your hands, arms, legs, and feet can be damaged, resulting in pain and numbness. Nerves in your bladder, stomach, and intestines can also be damaged, resulting in bladder and bowel problems, nausea, and vomiting. Hypertension increases the risk of diabetic neuropathy.10,11
- Stroke - Hypertension alone raises the chances of having a stroke, but people who also have diabetes are at a higher risk of having a stroke. Moreover, they’re also more likely to suffer a fatal stroke.12
How to Manage and Lower Your Blood Pressure with Diabetes
Hypertension and diabetes are both considered to be modifiable risk factors for the health conditions listed above. This means both conditions can be controlled or changed with medication, diet, and exercise. By eating fresh whole foods, moving your body, and reducing stress, you can lower your blood pressure and manage your diabetes.
Below are some lifestyle changes you can make to help optimize your blood sugar, help with diabetes management, and lower your blood pressure:
- Maintaining a Healthy Weight - Obesity is a major cause of both diabetes and hypertension.4 You reduce your risk of both conditions by losing weight and maintaining healthy body weight, you reduce your risk of both conditions.
- Physical Activity - A sedentary lifestyle increases your risk of insulin resistance, making you more likely to develop diabetes and cardiovascular disease. Exercise helps control blood sugar levels and strengthens your cardiovascular system. Just 25 minutes a day of physical activity can significantly reduce your risk of many chronic diseases.13
- Eat Healthy - Your diet plays a crucial role in developing and managing diabetes and hypertension. Prioritize a healthy diet by focusing on antioxidant-rich fruits and vegetables, whole grains, adequate protein, and healthy fats to better control your blood sugar and blood pressure.
- Quit Smoking - Smoking raises your blood pressure and increases insulin resistance which can lead to diabetes.14
- Manage Stress - High levels of stress trigger your nervous system to release chemicals that constrict your blood vessels. Over time this can result in hypertension.15 Additionally, elevated stress causes your body to release hormones that raise your blood sugar and interfere with insulin. Work to manage your stress through things like yoga, breathwork, and meditation.16
- Regular Check-Ups - Talk to your doctor to better understand your risks and determine the right lifestyle changes for you.
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References
- By the Numbers: Diabetes in America. (2022, October 25). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html
- Prevent diabetes complications. (2022, November 3). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/problems.html
- Diabetes and high blood pressure. (2021, August 8). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetes-and-high-blood-pressure
- Naha, S., Gardner, M.J., Khangura, D., et al. (2021, August 7). Hypertension in diabetes. Endotext - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK279027/
- Varghese, R. T., & Jialal, I. (2023, July 24). Diabetic nephropathy. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK534200/
- High blood pressure. (2023, August 29). Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/
- Facts about hypertension. (2023, July 6). Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/facts.htm
- Diabetes and your heart. (2022, June 20). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html
- What is Peripheral Artery Disease (PAD)? (2023, May 4). www.heart.org. https://www.heart.org/en/health-topics/peripheral-artery-disease/about-peripheral-artery-disease-pad
- Diabetes and nerve damage. (2022, June 20). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/diabetes-nerve-damage.html
- Ponirakis, G., Petropoulos, I. N., Alam, U., Ferdousi, M., Asghar, O., Marshall, A., Azmi, S., Jeziorska, M., Mahfoud, Z. R., Boulton, A. J. M., Efron, N., Nukada, H., & Malik, R. A. (2019). Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes. American journal of hypertension, 32(8), 796–803. https://doi.org/10.1093/ajh/hpz058
- Chen, R., Ovbiagele, B., & Feng, W. (2016). Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. The American journal of the medical sciences, 351(4), 380–386. https://doi.org/10.1016/j.amjms.2016.01.011
- Get active. (2022, November 3). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/active.html
- Smoking and diabetes. (2022, June 20). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/smoking-and-diabetes.html
- Kulkarni, S., O'Farrell, I., Erasi, M., & Kochar, M. S. (1998). Stress and hypertension. WMJ : official publication of the State Medical Society of Wisconsin, 97(11), 34–38.