High blood pressure (hypertension) is an important risk factor for the development and worsening of many complications of diabetes, including diabetic eye disease and kidney disease. It affects up to 60% of people with diabetes.

Having diabetes increases your risk of developing high blood pressure and other cardiovascular problems, because diabetes adversely affects the arteries, predisposing them to atherosclerosis (hardening of the arteries). Atherosclerosis can cause high blood pressure, which if not treated, can lead to blood vessel damage, stroke, heart failure, heart attack, or kidney failure.

Compared to people with normal blood pressure readings, men and women with hypertension have an increased risk of:

Coronary artery disease (heart disease)
Strokes
Peripheral vascular disease (hardening of the arteries in the legs and feet)
Heart failure

Even high yet normal blood pressure or pre-hypertension (defined as 120-139/ 80-89) impacts your health. Studies show that people with normal yet high range blood pressure readings, over a 10 year period of follow up time, had a two to three fold increased risk of heart disease.

What Should Blood Pressure Be if You Have Diabetes?

Blood pressure readings vary, but in general your blood pressure should not go above 130/80. The first number is the "systolic pressure" or the pressure in the arteries when your heart beats and fills the arteries with blood. The second number is the "diastolic pressure" or the pressure in the arteries when your heart rests between beats, filling itself with blood for the next contraction.

Having a normal blood pressure is as important to managing diabetes as having good control of your blood sugars when it comes to preventing diabetes complications.

What Are the Symptoms of High Blood Pressure?

Usually, high blood pressure has no symptoms. That's why it's so important to have your blood pressure checked on a regular basis (during all visits with your health care provider) and to follow your health care provider's recommendations on home blood pressure monitoring.

How Is High Blood Pressure Treated?

ACE (angiotensin converting enzyme) inhibitors are a group of medications that are often used to treat high blood pressure in people with diabetes. Although other high blood pressure medicines are available, ACE inhibitors have been shown to not only to be a useful drug to treat high blood pressure, but it has been shown to prevent or delay the progression of kidney disease in people with diabetes.

Note: Some blood pressure medicines may adversely affect your blood sugar level. Blood pressure medicines can also cause impotence. Talk with your doctor about the side effects of prescribed medicines.

Some blood pressures medications also seem to work better on certain populations of people. Diuretics for example seem to be particularly beneficial in the elderly and may also be beneficial in people with hypertension that is salt sensitive as is frequently seen in African Americans.

Other drugs used to treat high blood pressure in people with diabetes include a class of drugs known commonly as 'water pills' or diuretics.

Because adequate control of blood pressure usually requires more than one medication, most doctors use ACE inhibitors first then add other anti-hypertension drugs.