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Hypertension and Diabetes

WHAT YOU NEED TO KNOW:

Hypertension is high blood pressure (BP). Hypertension is common in persons with diabetes. This type of hypertension is called secondary hypertension. A normal BP is 119/79 or lower. You can control hypertension and diabetes with a healthy lifestyle, or a combination of lifestyle and medicine. Controlled BP and blood sugar levels help prevent certain complications from diabetes. Examples include retinopathy (eye damage) and kidney damage.

DISCHARGE INSTRUCTIONS:

Call or have someone call your local emergency number (911 in the US) for any of the following:

You have any of the following signs of a heart attack:

  • Squeezing, pressure, or pain in your chest
  • You may also have any of the following:
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Shortness of breath
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat
You have any of the following signs of a stroke:
  • Numbness or drooping on one side of your face
  • Weakness in an arm or leg
  • Confusion or difficulty speaking
  • Dizziness, a severe headache, or vision loss

Return to the emergency department if:

  • You have a severe headache or vision loss.
  • You feel faint, dizzy, confused, or drowsy.

Call your doctor or diabetes care team if:

  • You have been taking your BP medicine and your BP is still higher than your healthcare provider says it should be.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Medicine may be used to help lower your BP. You may need more than one type of medicine. Take the medicine exactly as directed.
  • Diuretics help decrease extra fluid that collects in your body. This will help lower your BP. You may urinate more often while you take this medicine.
  • Cholesterol medicine helps lower your cholesterol level. A low cholesterol level helps prevent heart disease and makes it easier to control your BP.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Manage hypertension and diabetes:

Talk with your healthcare provider about these and other ways to manage hypertension and diabetes:

  • Check your BP at home. Avoid smoking, caffeine, and exercise at least 30 minutes before checking your BP. Sit and rest for 5 minutes before you take your blood pressure. Extend your arm and support it on a flat surface. Your arm should be at the same level as your heart. Follow the directions that came with your BP monitor. Check your BP 2 times, 1 minute apart, before you take your medicine in the morning. Also check your BP before your evening meal. Keep a record of your readings and bring it to your follow-up visits. Ask your healthcare provider what your BP should be.
    How to take a Blood Pressure
  • Check your blood sugar level at home. Follow your healthcare provider's instructions and check your blood sugar level as directed. Keep a record of your blood sugar level readings and bring it to your follow-up visits. Ask your healthcare provider what your blood sugar levels should be.
    How to check your blood sugar
  • Manage any other health conditions you have. Health conditions such as kidney disease, thyroid disease, or adrenal gland disorder can increase your BP and blood sugar levels. Follow your healthcare provider's instructions and take all your medicines as directed.

Lifestyle changes you can make:

Talk with your healthcare provider about these and other lifestyle changes for hypertension and diabetes:

  • Limit sodium (salt) as directed. Too much sodium can affect your fluid balance. Check labels to find low-sodium or no-salt-added foods. Some low-sodium foods use potassium salts for flavor. Too much potassium can also cause health problems. Your healthcare provider will tell you how much sodium and potassium are safe for you to have in a day. He or she may recommend that you limit sodium to 2,300 mg a day.

  • Follow the meal plan recommended by your healthcare provider. A dietitian or your provider can help you create healthy meal plans. The plans will help you control sodium, carbohydrates, and fats in your meals. This can help you control both your blood sugar and BP levels. The plans usually include eating more fruits, vegetables, and low-fat dairy products. Your provider may talk to you about a Mediterranean style and Dietary Approaches to Stop Hypertension (DASH) eating plans. These eating plans can help you with weight loss and lowering your cholesterol.

  • Get regular physical activity. Physical activity can help decrease your blood sugar level. It can also help to decrease your risk for heart disease and help you lose weight. Adults should have moderate intensity physical activity for at least 150 minutes every week. Spread the amount of activity over at least 3 days a week. Do not skip more than 2 days in a row. Children should get at least 60 minutes of moderate physical activity on most days of the week. Examples of moderate physical activity include brisk walking, running, and swimming. Do not sit for longer than 30 minutes. Work with your healthcare provider to create a plan for physical activity.
  • Decrease stress. This may help lower your BP. Learn ways to relax, such as deep breathing or listening to music. Yoga and meditation may also help. Talk to your healthcare provider about ways to decrease stress.
  • Know the risks if you choose to drink alcohol. Alcohol can cause your blood sugar levels to be low if you use insulin. Alcohol can cause high blood sugar and BP levels, and weight gain if you drink too much. Women 21 years or older and men 65 years or older should limit alcohol to 1 drink a day. Men aged 21 to 64 years should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can increase your BP and make your blood sugar levels harder to control. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
    Prevent Heart Disease

Follow up with your healthcare provider as directed:

You will need to return to have your BP checked. You will also need other lab tests done, including an A1C to monitor your overall blood sugar control. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.