Facts People With Diabetes Should Know About Blood Pressure

Though there is still debate about what optimal blood pressure levels are, there is no question that high blood pressure can lead to stroke, heart attack, and vision problems.

Since diabetes is also associated with increased risk for cardiovascular disease and eye problems, knowing blood pressure (BP) facts and guidelines is important for long-term well-being.

BP Facts and Guidelines

While perusing these facts, keep in mind that hypertension, or high blood pressure is currently defined as a BP reading of 140/90 or higher.

• Age Factor. Though some genetically lucky individuals never develop high blood pressure, most people’s systolic pressure (the upper number) begins to rise around age 40. In the U.S., seven percent of the 18 to 39 age group has hypertension, as do 32 percent of those aged 40 to 59. In the 60 and above population, 65 percent are hypertensive.
• BP Numbers. The top BP number, or systolic pressure, is the one that matters most. It measures the force that arteries and organs experience as our heart beats. When this pressure becomes too high, it can harm eyes, kidneys, blood vessel linings, and the brain.
• The lower, or diastolic number indicates the pressure between heart beats. This number usually peaks when we're about age 55, then slowly declines.
• Detection. People can have pre-diabetes or type 2 diabetes for years and not know it. The same is true with high blood pressure. An elevated BP is typically revealed via reliable testing—not by experiencing symptoms.
• BP Debate. Controversy over what constitutes an optimal BP reading for older adults is being fueled by new research. For instance, systolic readings of 140 to 150 have been thought reasonable for individuals 50 to 60 and older. Yet, a recent five-year study showed that aggressively lowering the systolic number to 120 can greatly benefit seniors at high risk for stroke or heart attack.
• However, every body is different, so an “ideal” systolic number may never be determined. A higher systolic reading, for instance, might be acceptable for those with lower cardiovascular risk.
• Habits. Lifestyle changes may eliminate the need for medication with mild to moderate hypertension. For example, losing 11 pounds can drop a systolic reading by four points. We might lose five systolic points by reducing salt intake, and eating more fruits and veggies. Regular physical activity may trigger an 11 point reduction.
• Sodium. Though not all of us are sensitive to the effects of salt, taking in less than 1,500 mg of sodium per day is ideal for folks over 50. (A quarter teaspoon of salt is 575 mg of sodium.) We can reduce salt intake by limiting our consumption of processed foods, choosing low-sodium products when possible, and using more herbs to flavor our food.
• Medications. People with severe hypertension may take several blood pressure medications because an optimal dose of each drug typically lowers blood pressure by only a few points.
• Most individuals need their BP medications adjusted occasionally, so regular BP monitoring is recommended.
• Some over-the-counter medications can raise our BP several points, including cold medications with pseudoephedrine, and anti-inflammatories such as Motrin, Aleve, and Advil. If used regularly, these medicines could increase cardiovascular risk.
• BP Lows. People on hypertension medications should report dizziness upon standing to their physician. It may indicate orthostatic hypotension, or pressure too low to pump adequate blood to the brain. A dose or prescription change may be in order.

The most accurate way to monitor blood pressure is a 24-hour test that takes BP readings three or four times an hour during the day, and every half-hour at night. Since most insurance programs don’t cover this, physicians may recommend patients buy an automated upper-arm BP monitor to get reliable readings at home.

Source: Peter Jaret/AARP
Photo credit: Fort George G. Meade Public Affairs Office