High blood pressure is extremely common among Type 2 diabetics, estimated at 50% or more (some would say up to 90%). High blood pressure creates several problems in the individual with diabetes. It predisposes the person to heart disease, stroke, gangrene, blindness, kidney failure and nerve damage, in other words, all of the long-term complications of diabetes. Your doctor must watch and control your blood pressure meticulously.
What is a normal blood pressure in someone with diabetes? A major problem is that nobody knows. It is very clear that a diabetic should have lower blood pressure than a non-diabetic. The findings of several major studies are summarised below.
A systolic (the higher of the two numbers) blood pressure of 140 is too high for someone with diabetes. The risk of death for a diabetic can be reduced by 40% by decreasing the systolic blood pressure from 140 to 120! You should know your own blood pressure (BP), and demand to have it kept less than 130 if possible.
Studies have also demonstrated that a diastolic blood pressure (the lower number) of 85 is too high for someone with diabetes. Lowering the diastolic BP just 5mm to 80 will increase life expectancy and reduce the chance of heart attacks, strokes, and other problems. Exactly how much lower we should aim to get the BP is not yet clear, but more information is continually coming.
An individual with diabetes requires more medication to achieve an acceptable BP than a person who does not have the disease. It is not unusual to require three or more different types of medications to achieve this tight control of BP.