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Advice for people with diabetes and their families

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Diabetes and blood pressure

People with diabetes and high blood pressure are more at risk of having a heart attack or stroke. So it's important to know how to look after your blood pressure.

If you have diabetes, you need your blood pressure checked by a healthcare professional at least once a year. This check is part of your annual review.

If your blood pressure is high (called hypertension), you’ll need treatment to bring it down. This is because it puts a strain on your blood vessels and can damage them. This can make it harder for blood to flow around the body and reach all the vital areas it needs to, like your heart. And you’re more at risk of having a heart attack or stroke. It also puts you more at risk of developing all types of diabetes complications, like serious problems with your feet, your eyes and your kidneys.

There’s lots you can do yourself to help manage your blood pressure – because your lifestyle has a direct impact. But lots of people also need to take medication to treat high blood pressure and reduce the risk complications. 

It’s really important to know that you might have high blood pressure and feel fine, because there aren’t usually any symptoms. But even if you feel healthy, high blood pressure is damaging your blood vessels and you need to get treatment. That’s why you should never miss a blood pressure check – it’s a free test and takes two minutes.

What is blood pressure?

Blood pressure is the pressure your heart uses to push blood through your blood vessels and around your body. 

There are two numbers used to describe blood pressure and it’s measured in millimetres of mercury (mmHg). It’s written like this: 130/80mmHg. And you’ll hear your doctor say '130 over 80'. 

The first number is the systolic pressure. This is the most amount of pressure your heart uses when beating to push the blood around your body. 

The second number is the diastolic pressure. This is the least amount of pressure your heart uses when it is relaxed between beats. 

Using 130/80mmHg as an example, the systolic pressure here is 130mmHg and the diastolic pressure is 80mmHg.  

Our video below explains all about blood pressure, and how it affects people with diabetes. 

 

 

What is the recommended blood pressure range for people with diabetes?

It’s important to keep your blood pressure within a healthy range. This reduces your chances of your body developing further health complications.

Blood pressure should be below 140/80mmHg for people with diabetes or below 130/80mmHg if you have kidney or eye disease or any condition that affects blood vessels and blood supply to the brain. But it is important to speak to your healthcare team about your individual target. 

Whilst you may not have any symptoms of high blood pressure, it can be harmful to your health if left untreated. This is due to the increased pressure placed on your heart, eyes, kidneys and other organs. 

As we’ve said previously, heart attack or stroke are some of the conditions your body becomes more vulnerable to with high blood pressure. Other conditions you become more at risk of include: 

By reducing your blood pressure to healthier levels, you reduce your risk of getting these health conditions.

Symptoms of high blood pressure

High blood pressure is sometimes called a silent problem or the silent killer, as it usually has no symptoms. Some people with very high blood pressure say they have headaches, but that’s rare.

The best way to know if you have high blood pressure is to get it checked by a healthcare professional.

Causes and risk factors of high blood pressure

For most people, there’s no single cause of high blood pressure. But we know some things can make you more at risk. These are called risk factors, and one of these is having diabetes.

High levels of sugar in your blood can lead to something called atherosclerosis. This is when there’s a build-up of fatty material inside your blood vessels, narrowing them. The narrower the blood vessels, the more the pressure builds up.

The more stress your blood vessels are under, the harder it is to push blood around the important areas of your body. This means your feet, eyes and heart are seriously at risk. 

There are other risk factors you can’t do much about:

  • your age
  • a family history of high blood pressure
  • if your ethnic background is African-Caribbean or Black African

And there are risk factors you do have control over:

  • too much salt in your diet
  • being overweight
  • not being active
  • smoking
  • drinking too much alcohol
  • how you cope with stress
  • drinking too much caffeine, such as coffee

If you make changes to your diet and lifestyle, you can reduce your risk of developing high blood pressure. We’re not saying it’s easy, but it’s vital you understand how you can do this. There’s lots of support to help you bring your levels down and achieve your goals.

How to lower your blood pressure

A lot of lowering your blood pressure is down to making positive lifestyle changes. But we know it’s not always that straightforward, and some people will need medication to help too.

Your healthcare team can support you with making these changes. Find out what healthcare checks and services you are entitled to.

Your blood pressure test

Your doctor or nurse uses a blood pressure monitor to check your blood pressure. They’ll put a cuff (like a band) around your arm and inflate it. This restricts the blood flow for a few seconds. This can feel uncomfortable but isn’t painful. The cuff then deflates, the monitor takes a reading and your doctor or nurse will take the cuff off.

You should get this test at least once a year. It’s usually part of your annual review and is one of your essential diabetes health checks.

If you want to, you can buy a blood pressure monitor yourself to use at home. You can get this from a chemist or pharmacy, or order one from our shop. You don’t have to do this, but some people find it helps them manage their diabetes better. In some areas, diabetes care teams have suggested people buy their own home blood pressure monitoring kit, during the coronavirus pandemic while access to routine care is disrupted. You can find a list of blood pressure monitors to use at home from the British and Irish Hypertension Society website.

We know that won’t be possible for everyone, and we don’t think people should have to pay for these devices. We’re calling on the NHS to find other ways to make these available for free.

It’s fine to use a monitor yourself, but speak to your healthcare team first to make sure you’re using it right. Make a note of your readings and speak to your doctor or nurse if you’re ever worried.

Your blood pressure results 

You’ll get your results straight away. The reading on the monitor lets your healthcare team know whether your blood pressure is too high, too low or just right. But it’s important you understand your results too. Make a note of your reading at each appointment and get to know what the numbers mean. 

Your healthcare team will agree a target level that’s safe for you. It’s important you do everything you can to keep in your target range. The longer your blood pressure is high, the more at risk you are of getting serious complications. We’ve got lots of information and advice to help you bring your blood pressure down to the target level you've agreed with your healthcare team.

Medication for high blood pressure

Making changes to your lifestyle may not be enough and many people with diabetes also need to take medication.

The most common types of blood pressure medicines are diuretics, ACE inhibitors, beta-blockers, antiotensin-2 receptor blockers and, calcium channel blockers. Ask your healthcare team if want more info on these.

Your healthcare team may give you medication even if your blood pressure isn’t high and is in the target range. This is normal but you can ask your healthcare team to explain why. It’s usually because the medication itself can help protect you against diabetes complications – they especially protect your kidneys.

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