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Family Health Magazine
DIABETES

High blood pressure
Are you at risk?

If you have diabetes, you are at risk for high blood pressure. Knowing how to control your blood pressure reduces your risk of complications. Fortunately, your actions can make a big difference.

What is high blood pressure?

Blood pressure is the force pushing blood through your blood vessels. High blood pressure, or hypertension, is higher pressure in blood vessels than normal. Most people will not feel high blood pressure.

High blood pressure damages the lining of the blood vessels. With it, you have a higher risk of stroke, heart attack, heart failure, kidney failure, sexual dysfunction, problems with erections, and eye damage. If you have high blood pressure as well as diabetes, your risk of heart, kidney and eye disease increases even more. About 65 to 80 per cent of people with diabetes will die from cardiovascular events like heart attacks and strokes. Up to three-quarters of cardiovascular complications may be caused by high blood pressure. Lowering your high blood pressure reduces these risks.

What do blood pressure numbers mean?

Blood pressure (BP) is described using two numbers - For example 130/80 or 130 over 80. The unit of measurement for BP is millimetres of mercury (mm Hg). The top number is the systolic blood pressure. It occurs when your heart contracts and pumps blood, and is the higher of the two numbers. The bottom number is diastolic blood pressure. It occurs when your heart relaxes and fills with blood, and is the lower number.

The Canadian Diabetes Association and Canadian Hypertension Education Program recommend that if you have diabetes, your blood pressure should be less than 130/80 mm Hg. Your blood pressure goes up and down at different times and for different reasons. You do not necessarily have high blood pressure if it measures above 130/80 mm Hg on the first check. Check it twice more to be sure. Having diabetes means that you must check your blood pressure more often, even if it is currently below 130/80 mm Hg.

What can I do about high blood pressure?

Managing high blood pressure includes positive lifestyle changes. For many people, it means taking medications. Usually, both must begin at the same time. Lifestyle changes may help lower blood pressure. However, do not delay starting medication if your blood pressure is over 130/80 mm Hg. Many people with diabetes and high blood pressure need three or more medications to bring blood pressure down to target levels. If your blood pressure is over 150/90 mm Hg, your doctor will likely start you on two medications right away. It is really important to get that blood pressure down!

What lifestyle factors help to control your blood pressure?

Healthy eating – most people with diabetes follow a healthy meal plan. The same plan also works well for high blood pressure. Remember to eat a diet rich in fruits and vegetables, whole grains, low fat dairy products and fibre. Your meal plan should also be low in saturated fat, cholesterol and salt.

Healthy body weight – if you are overweight, even a small weight loss may reduce your blood pressure.

Sodium – most of us eat more salt (sodium) than we need. Hypertension Canada now recommends aiming for between 1200 and 1500 milligrams of sodium a day. Most of our sodium comes in prepared and packaged foods. Try to eat more fresh foods and prepare meals at home.

Regular physical activity – if you are not active now, (and unless your doctor recommends otherwise) gradually increase daily activity to 30 to 60 minutes at least four days a week. Brisk walking is an example. You might start with five or 10 minutes once or twice a day and gradually build up the length and the intensity or speed. If you are not currently active, check with your doctor before starting any new exercise program.

Limit alcohol – men should have less than 14 drinks a week, women less than nine. Of course drinks should be spread over the course of the week, with no more than two drinks a day.

Stay smoke-free – do not smoke, and try to avoid being in a smoky environment.

Monitoring your blood pressure

Check your own blood pressure with an approved blood pressure machine, at home or at your pharmacy. For more information about approved blood pressure machines go to www.hypertension.ca.

Keep a record of your blood pressure results – ask your doctor what your target blood pressure should be. When your blood pressure is higher or lower than your target, discuss it with your doctor so you can get prompt treatment.

Take your blood pressure record and medication to every medical or clinic visit.

Make sure your blood pressure is checked at each visit with your doctor or nurse.

Medications

You may need three or more kinds of medication to bring your blood pressure under control. Various kinds of blood pressure medications work on different areas in the body. Taking more than one kind of medication often helps to lower blood pressure. Medication only works if you take it. Do not stop it without talking to your health care provider.

Learn more about blood pressure

Hypertension Canada has developed a public information website for Canadians with high blood pressure. Sign up at www.myBPsite.ca. Members will receive notices of updated and new educational resources, a regular newsletter, supports to encourage a healthy lifestyle, and lectures. In the future, personal advice provided by a health care provider may be available. Members will be able to provide input on the need for new high blood pressure resources and suggest changes to current resources.

High blood pressure is a lifetime affair – it will not go away. Take charge of your health. Even when your blood pressure is under control, live a healthy lifestyle and take your medication as directed.