Risk Factors Associated With Diabetes And High Blood Pressure
Why should those with diabetes be aware of the risks of high blood pressure? Type 2 diabetes is caused by resistance to insulin, the hormone your body needs to use blood sugar for energy. Since the bodies of those with type 2 diabetes resist insulin, sugar builds up in their blood.
That means your body makes even more insulin, and insulin causes your body to retain salt and fluids, which is one way diabetes increases your risk for high blood pressure, said Dr. Hatipoglu. Over time, diabetes damages the small blood vessels in your body, causing the walls of the blood vessels to stiffen. This increases pressure, which leads to high blood pressure.
The combination of high blood pressure and type 2 diabetes can greatly increase your risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease and retinopathy.
Chronic high blood pressure can also contribute to early onset of conditions such as Alzheimers disease, dementia, and stroke because the blood vessels in the brain are particularly susceptible to damage due to high blood pressure.
How Do You Dose Diabetic Neuropathy Medications
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See Your Diabetes Educator
Work with a diabetes care and education specialist for help avoiding health complications such as heart disease. Youll get support and solutions and hear about the latest advances in managing diabetes. Find out more about how diabetes education can help you take the best care of yourself. And be sure to ask your doctor for a referral if you dont already have a diabetes educator.
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Diabetes May Contribute To Hypertension
Elevated blood sugar stresses the blood vessels. Damage to the vessels causes them to narrow and accumulate plaque. Plaque is composed of different substances like cholesterol, fats, and waste products. Plaque buildup narrows the vessels even more and forces the heart to work harder to pump blood.
When the heart has to work harder, the force at which the blood pumps through the body increases. This leads to high blood pressure.
Plaque formation and buildup cause atherosclerosis. This condition can increase the risk of heart attack, stroke, and peripheral arterial disease . PAD can include any number of diseases that impact the arteries that carry blood to distant parts of the body.
Diabetes Vasoprotection And Potential New Therapies
Data from landmark clinical trials in T2D including UKPDS, ADVANCE, and Action to Control Cardiovascular Risk in Diabetes demonstrate that treating comorbidities including hypertension and hypercholesterolemia is a more effective strategy for reducing cardiovascular complications than targeting blood glucose levels with conventional agents.109 Antihypertensive drugs such as angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, mineralocorticoid-receptor blockers, and calcium-channel blockers may have direct vasoprotective effects, and their use may contribute, at least in part, to reduced vascular complications in patients with diabetes and concomitant hypertension.110 Tight control of BP has been shown to reduce cardiovascular risk in T2D: most recent US and Canadian guidelines recommend a target of < 130/80 mm Hg.111, 112 Statin drugs and clopidrogel are also vasoprotective and may have extra benefit in patients with diabetes. Some of the beneficial effects of these drugs have been attributed to their antioxidant and anti-inflammatory properties.
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Diabetes High Blood Pressure And Chronic Kidney Disease
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CKD develops when the kidneys lose most of their ability to remove waste and maintain fluid and chemical balances in the body. CKD can progress quickly or take many years to develop.
How Do I Know If I Have High Blood Pressure
High blood pressure has been coined the silent killer for good reason. Often, there are no telltale symptoms. You can feel perfectly fine and still be suffering from hypertension. If your blood pressure becomes extremely elevated, you may notice symptoms including headache, lightheadedness, and blurry vision, however, theres also a good chance you wont feel any symptoms at all.
The only sure-fire way to know what your blood pressure is, is to measure it yourself or see your doctor. The most affordable and convenient way to pick up a high-quality blood pressure monitor is from an online supplier. They are relatively inexpensive, usually between $60 and $120, depending on the features you want and whether you prefer to measure your pressure around the upper arm or wrist. Also, when visiting your physician, checking your blood pressure is almost always a matter of routine.
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Types Of Diabetes And Their Symptoms
There are three kinds of diabetes, all of which have different causes:
Type 1 diabetes
Type 1 diabetes is an autoimmune disorder in which the body mistakenly attacks cells in the pancreas that produce insulin. The disease tends to appear during childhood or adolescence, though it can occur later in life.
Type 2 diabetes
Type 2 diabetes occurs as a result of insulin resistance. This is where body cells lose their ability to respond to insulin. The pancreas tries to compensate by producing more insulin, but the process is not sustainable.
Current guidelines recommend diabetes screening for everyone ages 45 years or above, and anyone younger who has risk factors for the disease. Early diagnosis and treatment can help slow or even reverse the disease, reducing the risk of complications.
does not have enough insulin to process glucose or their insulin does not work effectively. Insulin is the hormone that enables the body to process glucose from food and use it as energy.
When a person has insulin problems, glucose cannot enter their cells to provide energy, so it accumulates in the bloodstream instead.
High blood glucose levels can cause widespread damage to tissues and organs, including those that play a key role in maintaining healthy blood pressure. For example, damage to the blood vessels and kidneys can cause blood pressure to rise.
Mirnas Diabetes And Vascular Complications
miRNAs are a group of noncoding RNAs that are multifunctional. They fine tune gene expression and have been implicated in various pathologic processes, including T2D and the development of diabetic vascular complications. A number of pancreatic B-cellspecific miRNAs have been identified, including miR-375, miR-124a, miR-96, miR-7a, miR7a2, miR-30d, miR-9, miR-200, miR-184, and let-7.87 These play a role in pancreatic function, insulin secretion, and glucose tolerance. Differential miRNA signatures have been identified among prediabetic individuals, patients with diabetes, and patients with diabetes and vascular complications, suggesting that miRNAs may be novel biomarkers. Diabetic cardiovascular complications are associated with increased levels of miR-223, miR-320, miR-501, miR504, and miR1 and decreased levels of miR-16, miR-133, miR-492, and miR-373.9 Whether these changes in miRNA are simply biomarkers of disease or whether they are directly involved in the vasculopathy of diabetes remains unclear.
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Treatment Of Diabetes Mellitus And Its Cardiovascular Complications
Once T2D has been diagnosed, the aim of achieving glucose control is principally to avoid microvascular complications. There are some benefits with respect to macrovascular complications, but this is dependent on the profile of individual drug classes and even appears to be different for agents within the same class.88 The role of BP lowering to improve prognosis in T2D has been established since the UK Prospective Diabetes Study in 1998.89, 90 However, more recently, more widespread use of glucose-lowering agents that reduce weight, lower BP, and have beneficial off-target effects facilitates cardiovascular risk factor control and is playing a role in improving the cardiovascular prognosis of T2D.91, 92
Achieving glucose control in T2D begins with weight management. Particularly in the first 8 years after diagnosis, normal glucose tolerance can be restored if radical weight reduction can be achieved, most effectively using a very low calorie liquid replacement diet.93 In obese patients, this can also occur after successful bariatric surgery, particularly the Roux-en-Y procedure.94 The mechanism may involve reduction in ectopic fat, and consequent relief from its proinflammatory effects, in and around the pancreatic islets of Langerhans.95
How Common Is High Blood Pressure In People With Diabetes
In the UK, about 1 in 4 of people have high blood pressure . It is less common in younger adults. High blood pressure is more common in people with diabetes. Around 3 in 10 people with type 1 diabetes and around 8 in 10 people with type 2 diabetes develop high blood pressure at some stage.
People with diabetes are more at risk of developing high blood pressure if they:
- Are of African-Caribbean origin.
- Eat a lot of salt.
- Do not eat much fruit and vegetables.
- Do not take much exercise.
- Drink a lot of alcohol.
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What Causes High Blood Pressure
There are many things that can cause or increase a persons risk of high blood pressure. Its also important to keep in mind that sometimes high blood pressure can be the side-effect of another condition.
This means its critical that you are thoroughly examined and get proper bloodwork done after hypertension is identified.
Here are the most common risks and potential causes:
Now, lets take a closer look at the connection between high blood pressure and diabetes.
What Are The Benefits Of Lowering Blood Pressure
There is now plenty of good evidence from studies that controlling blood pressure in people with diabetes reduces the risk of future complications.
A large research study called the UK Prospective Diabetes Study confirmed this. In this study, many people with diabetes were monitored over several years. The study found that those with well-controlled blood pressure had nearly a third less risk of dying from complications related to diabetes compared with those with poorly controlled blood pressure.
In fact, this study found that good control of blood pressure was even more beneficial than good control of the blood sugar level to reduce the risk of developing complications from diabetes.
Since this study, other studies have been undertaken which confirm these results.
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How Your Body Regulates Glucose
Lets first review some basics about. The glucose in your blood serves as a primary source of energy for all the cells in your body. There are other molecules your body can make for fuel if needed, like ketones, but well keep the focus on glucose here for simplicity.
Your body has sensors throughout it to determine if you are at the correct blood glucose level. In people without, this level is typically between 70 and 120 mg/dL . There are multiple hormones that either activate or go quiet as needed to protect this glucose level. If the, your body might release catecholamine hormones to trigger an increase in the level of glucose in the blood. If, your body will release and other hormones to correct the level back down to an appropriate range.
People with diabetes dont lose the ability to raise or lower their blood sugar levels rather, the hormones that serve to keep blood glucose in the correct range dont function correctly, and the sensors that assess the glucose level are also often impaired.
The Connection Between Diabetes Kidney Disease And High Blood Pressure
It’s a triple health threat faced by tens of millions of Americans. But few think about it until they’re forced to.
Even then, the interplay between diabetes, high blood pressure and kidney disease can be a challenge for people to grasp. But doctors say having an understanding is key for anybody who wants to reduce their risk or already has the conditions, or who helps a family member with them.
It’s especially important for people who could benefit from new medications but face barriers slowing their use.
More than 34 million people, or 10.5% of the U.S. population, have diabetes, according to the Centers for Disease Control and Prevention. Most cases are Type 2, or adult-onset. When someone has diabetes, they can’t make or use insulin as well as they should. That causes blood sugar to rise, which leads to various complications throughout the body.
Dr. Vivek Bhalla, an associate professor of medicine and nephrology at Stanford University School of Medicine in California, summed it up: “Diabetes can affect small blood vessels. And that can result in hypertension. And that can also result in kidney disease.”
It can be a vicious cycle, said Bhalla, past chair of the American Heart Association’s Council on the Kidney in Cardiovascular Disease.
Much of that cycle goes on invisibly, Bhalla said.
A new generation of diabetes drugs could radically improve that.
Rangaswami said that highlights the need for doctors to better communicate with one another.
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High Blood Pressure: Symptoms And Tests
Your heart pumps about 2,000 gallons of blood throughout your body each day. The force at which the blood is pumped through your arteries is called blood pressure.
High blood pressure rarely has symptoms. The only way to know if you have it is to have your blood pressure checked by your doctor.
Elevated blood pressure doesn’t usually have symptoms. This is why itâs nicknamed the “silent killer.”
According to the American Heart Association, nearly half of Americans over the age of 20 have high blood pressure. Half of those with high blood pressure do not know they have it.
What Is Blood Pressure
Blood pressure is the pressure your heart uses to push blood through your blood vessels and around your body.
There are two numbers used to describe blood pressure and its measured in millimetres of mercury . Its written like this: 130/80mmHg. And youll hear your doctor say ‘130 over 80’.
The first number is the systolic pressure. This is the most amount of pressure your heart uses when beating to push the blood around your body.
The second number is the diastolic pressure. This is the least amount of pressure your heart uses when it is relaxed between beats.
Using 130/80mmHg as an example, the systolic pressure here is 130mmHg and the diastolic pressure is 80mmHg.
Our video below explains all about blood pressure, and how it affects people with diabetes.
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How Can You Lower Your Risk Of Type 2 Diabetes
Its possible to lower your risk of type 2 diabetes by making healthy changes to your lifestyle. The changes you can make to lower your blood pressure will also lower your risk of diabetes. In particular, keeping to a healthy weight, stopping smoking, eating a healthy diet, drinking less alcohol and getting active.
Pre-diabetes can be reversed with a , and getting diagnosed early means you can get the treatment and support you need to prevent type 2 diabetes from developing.
There are simple checks you can have to find out if you have diabetes or may be at risk:
- Find out if you’re at risk of type 2 diabetes this simple questionnaire calculates your risk of diabetes.
- Use this BMI calculator to find out if youre a healthy weight.
Type 2 Diabetes Mellitus And Hypertension
The prevalence of obesity and type 2 diabetes continues to rise worldwide as lifestyles associated with low energy expenditure and high caloric intake are increasingly adopted, particularly in lower-income and developing countries. It is predicted that the number of cases of T2D will rise from 415 million to 642 million by 2040.1 Hypertension is even more common, rising in prevalence in the same countries, with a recent worldwide estimate of 1.39 billion cases.2
Although T2D and hypertension can be simply diagnosed at the bedside, they are each complex and heterogeneous phenotypes associated with an elevated risk of life-threatening cardiovascular disease . Their frequent coexistence in the same individual is not a coincidence, because aspects of the pathophysiology are shared by both conditions, particularly those related to obesity and insulin resistance. For example, in the San Antonio Heart Study, 85% of those with T2D had hypertension by the fifth decade of life, whereas 50% of those with hypertension experienced impaired glucose tolerance or T2D.3
Vascular processes whereby diabetes and hypertension predispose to cardiovascular disease. Common risk factors promote diabetes and hypertension, which are associated with atherosclerosis, vascular inflammation, endothelial dysfunction, and structural remodelling, which lead to macrovascular and microvascular disease. Vascular damage and endothelial dysfunction is amplified when diabetes and hypertension coexist.
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