DIABETES AND HYPERTENSION: WHAT ARE THE LINKS BETWEEN THESE TWO DISEASES?

Real public health problems, arterial hypertension and diabetes are two frequently associated pathologies. In addition to damaging the walls of the arteries, they can increase the risk of developing other diseases. Often asymptomatic, they are sometimes difficult to diagnose. However, they must be identified as quickly as possible, so as not to cause serious complications.

What is the link between diabetes and hypertension? Does diabetes raise blood pressure? And how to avoid developing hypertension when you have diabetes?

High blood pressure and diabetes, two frequently associated diseases

Hypertension results in excessive blood pressure on the walls of the arteries. The leading cause of death in people with diabetes , the disease greatly increases the risk of developing cardiovascular and/or degenerative complications.

 

Common causes

In the vast majority of cases, high blood pressure (HTA) is not due to a direct cause: this is called “essential” hypertension . However, several factors increase the risk of suffering from this disease:

• age, ethnicity, family history and gender (women are more likely to suffer from high blood pressure during pregnancy or at menopause): these factors cannot be controlled or avoided. Certain medications and certain illnesses can also cause hypertension (this is called “secondary” hypertension);

• an unhealthy lifestyle : overweight or obesity, a diet that is too high in salt and low in fruits and vegetables, excessive alcohol consumption, smoking, insufficient physical activity or sports, excess bad cholesterol, poor quality sleep (caused, or not, by sleep apnea)…

In general, high blood pressure and diabetes share common causes, linked to the increase in obesity and physical inactivity. These two diseases also interact with each other : a hypertensive person has a greater risk of developing type 2 diabetes. A diabetic person has an increased risk of arterial hypertension.
 

What complications?

Associated, hypertension and diabetes can lead to several serious complications. Indeed, whatever the type of diabetes (type 1 or type 2), arterial hypertension necessarily worsens the vital prognosis of the diabetic patient.

The main complications are:

• heart failure (fatigue of the heart and shortness of breath), enlargement of the heart, aortic dissection, angina pectoris (poor oxygenation of the heart and pain on exertion or at rest), or myocardial infarction ("heart attack" );

• a cerebrovascular accident (CVA): it can be of ischemic origin (obstruction of a cerebral artery, with serious sequelae) or hemorrhagic (rupture of the artery or hemorrhage in the brain, with significant and disabling sequelae). People with diabetes are more likely to suffer from an ischemic stroke;

• arteritis of the lower limbs : the arteries in the legs narrow. Significant pain may appear if they become blocked, and amputation is sometimes necessary;

• kidney problems : damage to the kidney vessels, chronic kidney disease, even kidney failure;

• vision problems : damage to the vessels of the eyes (retina), even blindness (loss of sight);

• a neurodegenerative disease , such as Alzheimer's disease.

Complications of high blood pressure can be serious, especially when associated with diabetes. It is therefore essential to regularly monitor your blood pressure, especially in the case of diabetes.

 

How to detect hypertension in diabetic patients?

Reducing blood pressure in the diabetic patient reduces the risk of complications. It is therefore essential to measure your blood pressure regularly, to detect possible hypertension and take care of it.
 

Non-specific symptoms

Arterial hypertension is sometimes the cause of certain symptoms, which nevertheless remain uncharacteristic in people with diabetes: headaches (especially when waking up), dizziness and dizziness, ringing in the ears, visual disturbances (spots in front of the eyes), nosebleeds, difficulty concentrating, insomnia, nervousness, sweating, pain in the chest, palpitations, shortness of breath… But in general, the disease remains asymptomatic . It is then detected during a simple medical examination, or a consultation scheduled for another reason.

To prevent hypertension from being detected too late, it is therefore recommended to have your blood pressure checked regularly. The earlier it is diagnosed, the faster treatment can be instituted. If you don't have a blood pressure monitor, you can ask your pharmacist to check your blood pressure .

Blood pressure measurement, a simple and painless examination

Expressed in cmHg (centimeters of mercury), blood pressure (or pressure) is measured from two values:
- systolic blood pressure (maximum pressure, or PAS): this is the pressure recorded when the heart contracts and pushes the blood through the arteries;
- diastolic blood pressure (minimum pressure, or PAD): this is the pressure recorded when the heart relaxes to fill up with blood again.

Measurements are taken using a tensiometer (electric device equipped with an armband). At least two readings must be taken during the consultation, and at the level of both arms. The figure retained is the average of the figures displayed on the tensiometer.

When should you worry about blood pressure? “ Normal ” blood pressure is around 12 - 8 cmHg (maximum pressure between 10 and 14 - minimum pressure between 6 and 8). For the diagnosis of arterial hypertension to be confirmed, three successive measurements must reveal a pressure systematically greater than 14 - 9 cmHg (when carried out in a doctor's office), over a period of 3 to 6 months. In diabetes, blood pressure should not exceed 13.5 - 8.5 cmHg.

The doctor can also ask his patient to measure his blood pressure himself, directly at home (in particular to avoid the “white coat” phenomenon). Thanks to an autotensiometer (automatic blood pressure measurement device), the patient takes readings at different times of the day, and for several days. His blood pressure should then be below 13.5 - 8.5 cmHg.

 

What treatments?

As with diabetes, the best treatment for high blood pressure is to adopt new lifestyle and dietary rules and to modify some of your lifestyle habits. In some cases, a drug treatment must be put in place by the doctor.

 

Change some of your lifestyle habits

To balance blood pressure and diabetes, and thus avoid any risk of complications, it is recommended to:

• adopt good food hygiene : reduce salt consumption (harmful for the cardiovascular system when consumed in excess), eat a balanced diet (limit bad fats, salt and coffee, favor fruits, vegetables, cereals and fatty fish, etc.), limit alcohol consumption (which can increase blood pressure and render certain anti-hypertensive drugs ineffective). Don't hesitate to ask your doctor or pharmacist to find out more about the diet to adopt to prevent hypertension and diabetes;

• practice regular physical activity : favor moderate endurance sports (brisk walking, running, swimming, dancing, cycling, gentle gymnastics, etc.), walk at least 30 minutes a day, prefer stairs to elevators, etc.;

• control your weight : losing a few pounds can lower your blood pressure. Obesity is often the cause of diabetes and/or high blood pressure;

• stop smoking : smoking increases blood pressure and damages the heart and arteries. Your pharmacist can help you quit smoking ;

• reduce stress and sleep better : several activities help to fight against stress and insomnia (relaxation, meditation, yoga, sophrology, etc.). Preventing the body from recovering optimally, poor quality sleep can be the cause of poorly controlled blood pressure that is too high.

 

Undergoing medical treatment

Prescribed in addition to these lifestyle and dietary measures (when they are not enough to lower blood pressure), several drug treatments can control high blood pressure. They are prescribed according to the age and profile of the patient, the stage of the disease and its evolution.

 

The mechanisms of action of these drugs are different. If the first treatment is ineffective, the doctor can therefore combine several. To be effective, the treatment must be taken regularly.