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Understanding the Link Between Hypertension and Diabetes

Summary & Participants

Controlling blood sugar levels are crucial for people with diabetes. But equally important is blood pressure control. High blood pressure and diabetes often occur together and if left untreated can lead to serious consequences. Join experts as they discuss the link between these two conditions, who is most at risk and how it is diagnosed.

Medically Reviewed On: July 01, 2008

Webcast Transcript

MABEL JONG: Once you have discovered that you have it, what should you do about it?

WILLIAM WHITE, MD: You know, there's a lot of options. I think it depends on how severe it is when it is first diagnosed and what else actually is wrong with you. So if you have just high blood pressure with no other morbidities, that is, not diabetes, not heart disease, no evidence of stroke, no cholesterol problems, you don't smoke. In that instance, I think there's a true role for non-drug therapy, that is, using exercise, appropriate diets, watching salt intake, increasing other nutrients that might benefit the person from the standpoint of blood pressure effects.

Now, you take that same individual with the lower blood pressures, the more milder, stage I types, as we use in our terminology nowadays, and you add in other morbidities, such as a high cholesterol, a history of smoking a history of any kind of heart or kidney disease, a history of diabetes, then you really have to kind of accelerate the idea of using medications in that kind of individual.

MABEL JONG: Interesting. What are the risks of not controlling your blood pressure if you are indeed diagnosed with high blood pressure, Dr. Sica?

DOMINIC SICA, MD: Well, with high blood pressure, the risks are ominous. If you just have high blood pressure, as Dr. White just alluded to, you're a little bit safer with the disease and how it creates a specific risk, the risk then being stroke, development of coronary artery disease, congestive heart failure, peripheral vascular disease and end-stage renal disease or chronic renal failure.

MABEL JONG: Go over the normal levels and how a patient might be able to achieve those levels.

WILLIAM WHITE, MD: There's new guidelines that have been developed based on both the epidemiology, or population studies of diabetes and hypertension, and the results of treatment effects, and nowadays we look at the top number, the systolic blood pressure, as 130. We look at the diastolic blood pressure as about 80. So these are much lower values than in the past.

MABEL JONG: What public health or education challenges do these problems pose?

WILLIAM WHITE, MD: Well, if we take, let's say, the younger population in the United States, most young people after they finish college don't go to the doctor anymore. They don't have any reason, unless you are a woman going to see a gynecologist for routine care. So for about 20 years, many people don't get their blood pressure checked and they don't get their blood sugar checked.

One piece of advice that I would give to patients is that if you have a family history of diabetes or hypertension, your risk of developing these diseases is greater at an earlier age. We see increasingly, especially due to the obesity problem, a substantial number of individuals developing elevated blood sugars and blood pressures at much younger ages than in the past. Because of this, and because of poor dietary habits, we know that it needs to be screened and checked.

MABEL JONG: What about the elderly? Any special considerations there?

WILLIAM WHITE, MD: The elderly tend to go to the doctor a lot more, so they actually are diagnosed. But the issue with the elderly is the level of aggressiveness with which they and their physicians treat them.

MABEL JONG: Dr. Sica, do you have anything to add there?

DOMINIC SICA, MD: I think the substrate for much of heart disease is youth. The earlier we attend to matters and issues in life, the less likely it is when you get to the adult stage you can have a fully manifest disease.

MABEL JONG: Dr. White, some closing comments from you?

WILLIAM WHITE, MD: Well, I think that basically the new recognition of these new levels are important among physicians and their patients. We can tell you, as practicing physicians and as physicians who specialize in these disorders, that the treatment clearly links to improved outcome, that is, less morbidity, less strokes, less heart attacks, less heart failure, less kidney disease.

MABEL JONG: Important information. Dr. Sica, Dr. White, thank you again, for joining us today. And thank you for watching our webcast. I'm Mabel Jong.

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