For example, the researchers recommended for the general population an increase from 140/90 to 150/90 mm Hg. It was suggested that among adults age 60 and older with high blood pressure, the goal should be a target blood pressure under 150/90; among adults ages 30 to 59 with high blood pressure, a target blood pressure under 140/90; and among adults with diabetes or chronic kidney disease, a target blood pressure under 140/90. Even though the systolic and diastolic numbers are “higher,” doctors still recommend keeping blood pressure at a healthy low level and, if necessary, to make lifestyle changes to keep it low.
What are hypertension and hypotension?
Hypertension is another way of saying high blood pressure.
It is often referred to as a “silent killer.” This is because it usually has no obvious symptoms, meaning not many people are aware they have it.
In general, it occurs when a person’s blood is pumping through the heart and blood vessels with too much force.
It is usually found when a person has his or her blood pressure taken.
If one or both of the numbers in the systolic and diastolic blood pressure measurements are high compared with what is considered normal in the overall human population, it can be an indication of hypertension.
Although it is often a debated subject, it is thought that in healthy people, a blood pressure reading of 140/90 is considered normal (this often depends on whether the person’s physician has adopted the new guidelines or not; see above).
Hypotension means low blood pressure, in which a systolic pressure is below 100 mm Hg.
Most commonly, it is caused by overly aggressive treatment for hypertension.
Why is keeping a healthy blood pressure important to a person with diabetes?
High blood pressure is something a person with diabetes should try to prevent. This is mainly because high blood pressure can damage blood vessels, as does diabetes. Such damage from both conditions can greatly increase the risk of cardiovascular disease and other vascular problems.
What are some risk factors for hypertension?
In the general population, several risk factors are connected to hypertension.
For example, severe high blood pressure is three times higher for African Americans versus Caucasians.
Older people are at a higher risk for hypertension (it is estimated that almost half of the people age 74 and older have hypertension, whether they have diabetes or not).
If you are 35 or older, use oral contraceptives, or smoke, the risk of hypertension is increased.
If you are obese or have a body mass index higher than 30 (which is often associated with type 2 diabetes), then the risk for hypertension is greater.
And if you have diabetes or kidney disease, the risk of developing hypertension is greatly increased.
Who is affected by hypertension?
High blood pressure can affect any human on the planet.
Men, women, and children of all ages and all ethnic origins and races can have high blood pressure.
But certain conditions increase a person’s risk of developing hypertension.
Some of the most common reasons are obesity, physical inactivity, and an unhealthful diet.
High blood pressure has also often been tied to nicotine, salt, caffeine, and alcohol consumption in many studies.
In addition, it can be genetic, as it is often common in various families and in certain ethnic groups.
If a person’s blood pressure is too high, often from the narrowing of the arteries because of the buildup of fatty deposits on the walls (plaque), it can cause serious damage to the heart and blood vessels.
Such damage can cause the heart to lose its ability to pump well.
It can also cause blood vessels to lose their elasticity and ability to carry blood efficiently.
High blood pressure also increases the risk of stroke, heart attack, kidney failure, and congestive heart failure.
High blood pressure could lead to a number of serious ailments, from heart disease to even blindness and kidney failure.
Is there a “good” blood pressure reading for people who have diabetes?
The goal for patients with hypertension who do not have diabetes is usually 140/90 or below (not too low, but around that reading). For patients with hypertension and diabetes (or chronic kidney disease), the ideal goal has usually been a blood pressure of 130, 135/80 (said as 130, 135 [systolic] over 80 [diastolic]) or just below (readings depend on the study). But changes in blood pressure guidelines now propose a maximum target of 140/90.
What percentage of people with diabetes have hypertension?
It is estimated that about 30 percent of people ages 50 and over have hypertension.
Depending on the study, it is estimated that 20 to 60 percent of people with diabetes have high blood pressure.
Overall, it is known that hypertension often affects people with diabetes.
It is not known why there seems to be such a correlation between the two conditions.
But it may be a “concurrent” or “simultaneous” effect in which factors associated with both diseases, such as obesity, a high-fat and high-sodium diet, and inactivity, lead to both hypertension and diabetes.
Why are kidney disease, type 1 diabetes, and hypertension linked?
It is thought that hypertension in people with type 1 diabetes may be an indicator of kidney disease.
In fact, it is known that hypertension is one of the principal causes of diabetic kidney disease and kidney failure.
This occurs as blood vessels are damaged because of tension from high blood pressure.
Along with the higher blood pressure, if a person has diabetes, then elevated levels of glucose can also damage blood vessels.
And if the person also has high cholesterol, there is an even higher risk of blood-vessel damage. (For more about diabetes and kidney disease, see the chapter “How Diabetes Affects the Urinary System.”)
Does salt affect blood pressure, especially if a person has diabetes?
Most health care professionals agree that, for most people, ingesting too much salt can cause the body to develop high blood pressure over time.
In fact, eating too much salt causes the body to hold extra water in order to eliminate the salt from the person’s system.
For some people, this causes extra pressure in the blood, causing a rise in blood pressure.
The additional water also puts stress on the blood vessels and heart, and when the blood pressure increases, it puts even more pressure on the blood vessels and heart.
Thus, the American Heart Association suggests that people with high blood pressure, or a tendency toward developing high blood pressure, should eat foods lower in salt, along with lower amounts of fats and calories.
The AHA also recommends that a person ingest no more than 1,500 milligrams of sodium per day.
To compare, a teaspoon of salt is about 2,400 milligrams of sodium. (This number has recently been highly debated; for more about the sodium controversy, see the chapter “Diabetes and Nutrition.”)
For a person with diabetes, the effect of salt on blood pressure is also an issue. According to the Joslin Diabetes Center, having diabetes does not mean having to cut salt and sodium from the diet. However, people with diabetes should cut back on their sodium intake since they are more likely to have high blood pressure, a leading cause of heart disease, than people without diabetes.
Consuming too much salt is never a good idea because it affects high blood pressure, which is also an issue with diabetics, of course.
Do some high blood pressure drugs affect the body’s insulin levels?
Yes. Drugs to lower high blood pressure can have different effects on insulin sensitivity in the body. The best way to find out which drugs have such effects is to ask a health care provider about the interactions of certain medications with the body’s insulin. For a person who has prediabetes or diabetes, such questions are necessary, since insulin balance is so crucial to keeping the blood glucose in a healthy balance.
What recent study showed a possible link between the time a person takes his or her high blood pressure medication and type 2 diabetes?
In a recent study, scientists uncovered a possible link between the time when a patient takes blood pressure medication and that person’s risk of developing type 2 diabetes.
Unlike people without high blood pressure (hypertension), people with high blood pressure do not experience a drop in blood pressure at night (called “non-dipping”).
The researchers monitored people without diabetes, and a certain percentage of them had hypertension.
After six years of monitoring the patients, the researchers found that the “non-dippers” were at higher risk of developing type 2 diabetes, while those whose blood pressure dropped at night were at a lower risk.
The researchers also did a separate experiment, in which half the participants with high blood pressure took their blood pressure medication in the morning, while the other half took the medication before going to bed.
They found that the participants who took their medications at bedtime not only lowered their nighttime blood pressure but also lowered their risk of developing type 2 diabetes by 57 percent compared with those who took the medication in the morning.
Overall, the scientists believe that the connections between type 2 diabetes and blood pressure may be hormonal.
For instance, hormones such as adrenaline and angiotensin both contribute to high blood pressure and type 2 diabetes.
Thus, for example, when angiotensin is targeted by blood pressure medications and therefore lowered, so is the risk of developing high blood pressure and diabetes.
More studies have to be conducted before people change their medications, which is why it is best for a person with diabetes and/or high blood pressure to discuss such possible interactions with a health care professional.
Can high blood pressure be “cured”?
According to most health care researchers, high blood pressure cannot be “cured,” but it can be controlled in many ways. For example, most doctors treat high blood pressure patients with medication and/or through lifestyle modification, with both directed by the health care professional. Overall, a person with diabetes should discuss blood pressure goals with the health care professional.
DIABETES AND BLOOD
What are the main components of human blood?
Blood is considered a complex tissue, or group of similar cells, suspended in a fluid medium for easy transport through blood vessels. The following lists the four main components of human blood:
Plasma , Plasma is the liquid portion of the blood, and its principal component is water. Within the water are necessary elements that allow humans to live, especially dissolved salts, nutrients, and gases, along with molecular wastes being removed. It also contains clotting factors, hormones, enzymes, and antibodies.
Red blood cells , The red blood cells, scientific name, erythrocytes, are the most abundant cell type in the blood fluid.
These dish-shaped cells measure about 8 micrometers in diameter.
They lack a central nucleus like many other types of cells and cannot reproduce.
But they have an extremely important job as they carry hemoglobin (a red, oxygen-carrying pigment that, when bound to oxygen, is called oxyhemoglobin) and oxygen throughout the body.
These cells only live about 120 days, forming in the bone marrow and being recycled in the liver.
Human blood is composed of plasma, red blood cells, platelets, and white blood cells.
White blood cells , White blood cells are also formed in the bone marrow. They die off fighting infections and are one of the major components of pus.
Platelets , Platelets, scientific name thrombocytes, are small, non-cellular components (actually cell fragments) that form in the bone marrow from megakaryocytes (large bone marrow cells) and are the main reason blood clots so well.