HIGH BLOOD PRESSURE, DIABETES, HEART DISEASE AND STROKE

High blood pressure, also called hypertension, means that the force of the blood inside your blood vessels is too high. High blood pressure makes the heart work too hard, and can increase your risk for heart attack and stroke. People with diabetes are more likely to have high blood pressure than people without diabetes. In fact, almost 2 out of 3 adults with diabetes have high BP. Both high BP and diabetes increase your risk of heart disease, stroke, eye problems, kidney problems, and nerve disease. So if you have both, you have an even greater risk for other health problems.

What’s the target blood pressure for people with diabetes?

For most people with diabetes, keeping blood pressure below 130/80 will help prevent problems. BP is recorded as two numbers. The first number is the pressure as your heart beats and pushes blood into the blood vessels (systolic blood pressure). The second number is the pressure when your heart rests between beats (diastolic blood pressure). Both numbers are important. 

If my blood pressure is too high, what can I do to lower it?

You should

1 Use a meal plan

2 Eat less salt

3 Exercise

4 Take blood pressure medicine

Several medicines can lower blood pressure. Some blood pressure medicines have been shown to protect your kidneys from disease and to reduce your chance for having a heart attack or stroke. Talk with your endocrinologist about the best medicine for you. Often, more than one medicine may be needed to lower your blood pressure.

HEART DISEASE

People with diabetes have extra reason to be mindful of heart and blood vessel disease.  Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation.

Coronary heart disease (CHD) is the leading cause of death for both men and women with diabetes. CHD is caused by a narrowing of the coronary arteries that supply blood to the heart, and often results in a heart attack.

Fortunately, everyone can take steps to protect their heart–and their life or that of someone else. The key is seeking medical care as soon as possible.

Risk factors are conditions that increase your risk of developing heart disease. Some can be changed and some cannot. Although these factors each increase the risk of CHD, they do not describe all the causes of coronary heart disease; even with none of these risk factors, you might still develop CHD. The risk factors are:

High blood pressure
High blood cholesterol
Smoking
Obesity
Physical inactivity
Diabetes mellitus
 

What are the symptoms of CHD?

Chest pain (angina) or shortness of breath may be the earliest signs of CHD. A person may feel heaviness, tightness, pain, burning, pressure, or squeezing, usually behind the breastbone but sometimes also in the arms, neck, or jaws. These signs usually bring the patient to a doctor for the first time. Nevertheless, some people have heart attacks without ever having any of these symptoms.

It is important to know that there is a wide range of severity for CHD. Some people have no symptoms at all, some have mild intermittent chest pain, and some have more pronounced and steady pain. Still others have CHD that is severe enough to make normal everyday activities difficult.

Because CHD varies so much from one person to another, the way a doctor diagnoses and treats CHD will also vary a lot.

Are there tests for CHD?

There is no one simple test--some or all of the following procedures may be needed. These diagnostic procedures are used to establish CHD, to determine its extent and severity, and to rule out other possible causes of the symptoms. After taking a careful medical history and doing a physical examination, the doctor may use some tests to see how advanced the CHD is. The only certain way to diagnose and assess the extent of CHD is coronary angiography; other tests (ECG, exercise stress test, nuclear scanning) can indicate a problem but may not clearly show exactly where it is.

How is CHD treated?

CHD is treated in a number of ways, depending on the seriousness of the disease. For many people, CHD is managed with lifestyle changes and medications. Others with severe CHD may need surgery or a balloon procedure. In any case, once CHD develops, it requires lifelong management.

If you have diabetes, your endocrinologist may suggest that you go for periodic evaluations to see if there is heart disease. This is very important so that heart disease may be halted or treated.