Post updated: 11th May 2023

High blood pressure or hypertension often occurs alongside type 1, type 2, as well as gestational diabetes, and research shows that the two may be connected. Both diabetes and hypertension share some underlying causes, and they have some risk factors in common.  Both conditions also contribute to the aggravation of each other’s signs and symptoms.

Let’s explore the link between diabetes and high blood pressure, how to detect both conditions and how to reduce their negative impact.

Risk factors for hypertension with diabetes

High blood pressure is a condition that is commonly seen in type 2 diabetes patients. The ADA reports that a combination of type 2 diabetes and high blood pressure is particularly dangerous and raises the risk of a stroke or heart attack.

Having both conditions (high blood pressure and diabetes) also increases the risk of developing other complications such as retinopathy and kidney disease.

Studies show that consistently high blood pressure speeds the arrival of mental problems such as dementia and Alzheimer’s disease. This is largely attributed to the fact that vessels in the brain are highly vulnerable to damage as a result of hypertension. This makes high blood pressure a major risk factor for dementia and stroke.

Although it’s still unclear why the two conditions are closely related, it is believed that certain factors contribute greatly to high blood pressure and diabetes. These factors include:

• Chronic inflammation
• A diet high in sodium and fat
• Obesity
• A sedentary lifestyle
• Current smoking habits
• A family history of heart-related complications
• High cholesterol
• Too much alcohol
• Advanced age
• Chronic diseases such as sleep apnea, diabetes, and kidney disease

Hypertension is commonly referred to as “the silent killer” largely because it usually has no noticeable symptoms. According to a 2013 study by the ADA (American Diabetes Association), less than 50% of people at risk of type 2 diabetes or heart disease discussed biomarkers such as high blood pressure with their doctors.

Identifying high blood pressure

Most people find out they have hypertension when they take a blood pressure reading. The reading gives two numbers:

• The top number (systolic)
• The bottom number (diastolic)

According to the AHA (American Heart Association), the reading will be one of the following:

Blood pressure chart

Blood pressure category	Upper number mm Hg (systolic)		Lower number mm Hg (Diastolic)
Normal	Lower than 120	and	Lower than 80
Elevated	120 – 129	and	Lower than 80
High blood pressure (Stage 1)	130 – 139	Or	80 – 89
High blood pressure (Stage 2)	140 or higher	Or	90 or higher
Hypertensive crisis (Seek medical attention immediately)	Above 180	and/or	Above 120

High blood pressure simply means that blood pumps through the blood vessels and heart with too much force. Eventually, high blood pressure can tire the heart muscle and enlarge it. Studies show that the blood pressure rates of 67% of American adults with diabetes (self-reported) were more than 140/90 mm Hg (millimeters of mercury).

Diabetes and high blood pressure complications

The combined effect of high blood pressure and diabetes increases the risk of various life-threatening complications including kidney disease and cardiovascular disease. According to a 2012 study, 50 to 80% of type 2 diabetes patients and up to 30% of type 1 diabetes patients have hypertension.

There are 3 main ways in which high blood sugar levels can contribute to an increase in blood pressure:

• Blood vessels become rigid
• Fluid retention increases especially when the kidneys are affected
• Insulin resistance tends to affect processes that may increase the risk of high blood pressure.

Controlling diabetes and blood pressure prevents complications.

Healthy tips for managing high blood pressure:

Tips for reducing blood pressure include:

• Regularly visiting a physician and taking advantage of blood pressure screening
• Maintaining a healthy weight
• Exercise: The AHA recommends either 75 minutes of vigorous exercise per week, 150 minutes of moderate-intensity exercise per week, or a combination of vigorous and moderate exercise each week.
• Limiting salt intake to 1 tsp (2 g) per day
• Eating a low-sugar diet but plenty of fish, vegetables, healthy fats, whole grains, and fruits.
• Drinking in moderation
• Avoiding NSAIDs (non-steroidal anti-inflammatory drugs) which tend to raise blood pressure

Making some lifestyle changes not only reduces health complications associated with diabetes but also significantly reduce the risk of hypertension.

In fact, studies show that lowering the systolic pressure by about 10 points helps reduce all diabetes-related complications by up to 12%.