When you have high blood pressure and diabetes at the same time, diabetes is the fire and high blood pressure is the fuel for the fire. High blood pressure can further increase the health damage of diabetes by increasing inflammation and blood vessel damage, it can promote kidney disease and heart attacks, and it can increase the risk of stroke.
Studies show that the ideal blood pressure to prevent these and other diabetes complications should be less than 120/80 mm Hg. By all means, discuss with your doctor how to achieve this ideal blood pressure range.
If your blood pressure is slightly above normal, your doctor may recommend a low-salt diet and exercise. Limit sodium to 2300 mg per day – about a teaspoon of salt. High blood pressure can be stopped with a diet similar to a weight loss program or the DASH diet, a low-salt diet that includes many nutrients such as potassium and magnesium to help lower blood pressure. If you have end-stage renal disease, you may have to limit your potassium intake.
Sleep is also critical. In fact, sleep is just as important as salt restriction to control blood pressure and diabetes. If you get at least 6 to 7 hours of sleep a night, your blood pressure and blood sugar will improve dramatically.
For a period of time, antihypertensive medications can be stopped simply by reducing salt intake and weight loss, but then they may still be needed. Once the highest (or systolic) blood pressure value is well above 130 mmHg, or if you have had hypertension for 4 to 6 years, or if you have signs of complications such as kidney or retinal damage, you may have to take at least one antihypertensive medication in addition to relying on diet and exercise. Some of these medications are more effective than others in patients with diabetes. Diuretics and several beta-blockers can raise blood glucose. Therefore, it is usually recommended to start with a calcium channel blocker or an angiotensin II receptor blocker (ARB), both of which have a lesser effect on blood glucose.
If one medication fails to lower blood pressure, your doctor can add one or two more classes of medications. Once the medication is started, it is important to stay on it. If you stop taking the medication because your blood pressure is well controlled, the cardioprotective and vascular effects previously established by taking the medication will be gone within a few days.