Diabetes and High Blood Pressure

Medically Reviewed by Michael Dansinger, MD on May 21, 2023
2 min read

High blood pressure (hypertension) can lead to many complications of diabetes, including diabetic eye disease and kidney disease, or make them worse. Most people with diabetes will eventually have high blood pressure, along with other heart and circulation problems.

Diabetes damages arteries and makes them targets for hardening, called atherosclerosis. That can cause high blood pressure, which if not treated, can lead to trouble including blood vessel damage, heart attack, and kidney failure.

Compared to those with normal blood pressure readings, people with hypertension more often have:

  • Coronary artery disease or heart disease
  • Strokes
  • Peripheral vascular disease, hardening of the arteries in the legs and feet
  • Heart failure

Even blood pressure that's at the higher end of normal (120/80 to 129/80), called elevated, impacts your health. Studies show that you have a two to three times greater chance of getting heart disease over 10 years.

Readings vary, but most people with diabetes should have a blood pressure of no more than 130/80.

The first, or top, number is the "systolic pressure," or the pressure in your arteries when your heart squeezes and fills the vessels with blood. The second, or bottom, number is the "diastolic pressure," or the pressure in your arteries when your heart rests between beats, filling itself with blood for the next contraction.

When it comes to preventing diabetes complications, normal blood pressure is as important as good control of your blood sugar levels.

Usually, high blood pressure has no symptoms. That's why you need to check your blood pressure regularly. Your doctor will probably measure it at every visit, and you may need to check it at home, too.

Many of the things you do for your diabetes will also help with high blood pressure:

  • Control your blood sugar.
  • Stop smoking.
  • Eat healthy.
  • Exercise most days.
  • Keep your weight in a healthy range.
  • Don't drink a lot of alcohol.
  • Limit how much salt you eat.
  • Visit your doctor regularly.

Most doctors use ACE inhibitors (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) first. Although other medications treat high blood pressure, these also prevent or slow kidney disease in people with diabetes.

Some blood pressure drugs may make your blood sugar and lipid levels worse. Blood pressure medicines can also cause erectile dysfunction. Find out from your doctor what your prescribed medicines might do.

Other drugs known commonly as "water pills" or diuretics help your body get rid of extra fluid.