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Diabetes Blood Pressure Target

Roughly one in 3 American adults have high blood pressure, and many are not even aware. This is because hypertension often does not cause symptoms if the levels are not very high. However, high blood pressure is a leading cause of disability and death because it damages the blood vessels and increases the risk of heart attacks, heart failure, stroke kidney diseases, and dementia.

 For individuals with diabetes, keeping the blood pressure levels healthy is particularly important because those who have diabetes and high blood pressure are 4 times more likely to develop heart complications compared with someone who does not have either of these conditions. Other complications include eye, nerve, and kidney diseases. 

Blood pressure readings

Blood pressure is expressed as two numbers. The first number is the systolic blood pressure which represents the pressure in the blood vessels when the heart beats. The second number is diastolic blood pressure which is the pressure when the heart relaxes. 

The safest blood pressure is 120/80 mmHg or less, but not below 90/60 mmHg which defines low blood pressure. It is normal for the blood pressure to fluctuate throughout the day. Thus, the diagnosis of hypertension is based on an average of two or more readings taken on 2 or more occasions. Blood pressure should ideally be checked in both the right and left arm to assess if there’s a difference. For accurate readings,  it is important to use the right size arm cuff.  Blood pressure monitors that measure the blood pressure at the wrist or finger seem to be less reliable and thus are not recommended by the American Heart Association. 

What is the target blood pressure for a diabetic?

The target blood pressure for those with diabetes is to maintain blood pressure less than 130/80 mmHg. The same readings are ideal for people with chronic kidney diseases or coronary artery diseases, too. 

Unfortunately, about two-thirds of adults with diabetes have blood pressure higher than 130/80 mm Hg or they need to use prescription medications for hypertension, according to Johns Hopkins Medicine.

Here are some general rules to consider. 

  • If the blood pressure is below 120/80 mmHg, it is great. This is considered a normal blood pressure. The recommendations are to maintain or adopt a healthy lifestyle. 
  • A systolic  blood pressure is  120-129 mmHg and the  diastolic blood pressure is below 80 mmHg, it is  considered elevated blood pressure.  The recommendations are to regularly monitor blood pressure, maintain or adopt a healthy lifestyle. 
  • A systolic blood pressure is over 130 mmHg and the diastolic blood pressure is over 80 mmHg, which means have high blood pressure. In addition to maintaining or adopting a healthy lifestyle and talking to  the doctor about taking one or more drugs for blood pressure control. Stage 1 high blood pressure is considered between 130-139mmHg for systolic blood pressure and 80-89 mmHg for diastolic pressure. Stage 2 hypertension is defined as 140 or higher mmHg systolic and 90 or higher for diastolic blood pressure. 
  • Blood pressure higher  than 180/120 mm Hg is considered an emergency. If taken at home, it is important to  relax, take deep breaths and retake after 5 minutes. If the readings are still high, medical advice should be sought  right away.  Other symptoms like chest pain, vision problems or shortness of breath along with very high blood pressure require a 911 call and emergency evaluation. 

Blood pressure -prevention and treatment 

The following can  prevent  or delay the onset of hypertension :

  • Reduced salt intake. Ideally 1,500 mg a day or less. This means cutting down on processed foods and replacing salt with herbs and spices
  • Engagement  in stress-relieving activities such as deep breathing, yoga or meditation 
  • Regular exercise.  A fitness program that includes  150 minutes a week, or roughly  30 minutes most days of the week can help reduce  blood pressure by about 5 to 8 mm Hg
  • Reduce excess weight. According to Mayo Clinic experts, weight loss is one of the most effective strategies to control blood pressure in individuals who are overweight or obese.  Even small amounts of weight loss can help. For example, the blood pressure can be decreased by about 1 mm Hg with each kilogram of weight lost. For men, the goal is to have waist measurement less than 40 inches and for women less than 35 inches.
  • Avoid excessive alcohol intake. An occasional drink is fine. However, drinking more than moderate amounts of alcohol can increase blood pressure by several points and  decrease  the effectiveness of  medications for blood pressure. 
  • Stop smoking and reduce exposure to secondhand smoke. Blood pressure goes up for a number of minutes after smoking a cigarette. On the other hand, stopping smoking helps improve blood pressure readings and reduce the risk of heart disease and other complications. 

In terms of treating high blood pressure, the doctor will have to take into consideration the age, medical history, associated conditions, tolerance to certain blood pressure medications and preference. Lifestyle changes to improve diet, fitness levels, sleep and stress management are all important to better keep the blood pressure levels in check. 

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