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Written by Dr Serena Jones, GP
Dr Serena graduated from Manchester University in 2008 (MBChB).
She also holds the MRCGP, DRCOG and DFSRH.
Diabetes mellitus and hypertension (raised blood pressure) are both chronic health conditions that can present with little or no symptoms.
In several studies, type 2 diabetes mellitus (T2D) has been associated with an increased risk of hypertension, and vice versa; however, a specific link between these conditions remains to be determined [1].
Diabetes and hypertension often co-exist. They can individually lead to serious complications if left untreated, and the risks of complications greatly increase when both are present.
There are massive health benefits to actively monitoring and managing both conditions.
What are the risk factors?
Both diabetes and hypertension share similar risk factors, these include:
- Obesity: Excess weight increases blood pressure and makes it harder for the body to regulate insulin. The accumulation of fat around the abdomen is particularly problematic.
- Sedentary Lifestyle: A lack of physical activity can lead to weight gain and insulin resistance, elevating the risk of both conditions.
- Unhealthy Diet: High-salt, high-fat, processed foods, too much alcohol and high-sugar diets are all associated with both hypertension and diabetes.
- Genetics: Family history can increase the likelihood of developing both conditions [2].
How does hypertension affect diabetes?
Hypertension exacerbates the complications of diabetes in several ways:
- Cardiovascular Disease: High blood pressure puts additional strain on blood vessels. For people with diabetes, this is particularly dangerous as they already have a higher risk of heart disease. The combination of diabetes and hypertension accelerates atherosclerosis (hardening of the arteries), increasing the risk of heart attacks and strokes.
- Kidney Damage: Both hypertension and diabetes damage the small blood vessels in the kidneys. Over time, this can lead to chronic kidney disease or even kidney failure.
- Retinopathy: Diabetes can damage the blood vessels in the retina (diabetic retinopathy), and hypertension makes this worse. High blood pressure increases the risk of retinal damage, leading to vision problems or blindness if left untreated.
- Insulin Resistance: This can lead to high blood sugar levels. Insulin resistance is also associated with increased sodium retention, which can cause high blood pressure. Over time, insulin resistance contributes to both hypertension and cardiovascular issues [3].
Prevention and management of diabetes and hypertension
Managing blood pressure effectively can help control blood sugar levels and vice versa.
Preventing or managing these conditions simultaneously can be challenging, it involves:
- maintaining a healthy diet (see our article on the “DASH diet”),
- regular physical activity,
- weight control, and,
- if necessary, medications.
Early detection and consistent monitoring are essential to reduce the risk of complications and improve outcomes. Having a home blood pressure monitor and checking your blood pressure may allow you to identify raised blood pressure at an earlier stage, before serious damage is done.
So, is there a link between hypertension and diabetes?
It’s highly likely that there is a link between diabetes and hypertension. Having one of these conditions raises the risk for the other to be present also.
By adopting a holistic approach that combines lifestyle changes, medications and regular monitoring, can improve quality of life and reduce the risk of serious complications.
References:
- Circ Res. Dianjianyi Sun1, Tao Zhou 1 2, Yoriko Heianza 1 et al. Type 2 Diabetes and Hypertension. 2019 Mar 15;124(6):930-937.
- Diabetes UK: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/blood-pressure
- British heart foundation: https://www.bhf.org.uk/informationsupport/risk-factors/high-blood-pressure
