Question: How Can I Lower My Blood Pressure?

Medically Reviewed by Brunilda Nazario, MD on July 21, 2016
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When you have both high blood pressure and diabetes, diabetes is the fire and high blood pressure is the gasoline being added to the fire. High blood pressure adds to the harmful health effects of diabetes by increasing inflammation and damage to your blood vessels. It can encourage kidney disease and heart attacks, and it can raise your odds of having a stroke.

Research shows that the ideal blood pressure for preventing these and other diabetes complications is less than 120/80. However, talk to your doctor about the ideal range for you and how to achieve those numbers.

If your blood pressure is slightly above normal, your doctor will probably recommend a low-salt diet and exercise. Limit sodium to 2,300 milligrams a day -- about one level teaspoon of salt. You can follow a diet similar to the dietary approaches to stop hypertension, or DASH, which is low in salt and includes a mix of nutrients such as potassium and magnesium that help bring down blood pressure (though you might have to limit potassium if you have late-stage kidney disease).

Sleep is also important. In fact, it's as important as limiting salt for controlling blood pressure and diabetes. You'll get amazing improvements in both blood pressure and blood sugar if you sleep at least 6 to 7 hours a night.

You can avoid having to use blood pressure drugs for a while just by lowering your salt intake and losing weight, but you'll probably still need to take something down the road. Once your top (or systolic) blood pressure number is well above 130, you've had high blood pressure for 4 to 6 years, or you have signs of complications such as kidney or retina damage, you'll almost certainly need to go on at least one blood pressure drug in addition to relying on diet and exercise. Some of these drugs are better than others for people with diabetes. Diuretics and many of the beta-blockers can raise blood sugar. So instead, I'll start with a calcium blocker or angiotensin II receptor blocker (ARB), both of which have less of an effect on blood sugar.

If one drug doesn't lower your blood pressure, your doctor can add one or two more medicines. Once you start, you'll have to stay on them. If you decide that your blood pressure is well controlled and stop taking the medicine, all the heart and blood vessel protection you've built up will be gone within a few days.

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George Bakris, MD, professor of medicine and director of the ASH Comprehensive Hypertension Center, The University of Chicago Medicine.

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