Understanding the Relationship Between High Blood Pressure and Type 2 Diabetes

Most people with type 2 diabetes also suffer from high blood pressure, which has very few noticeable symptoms, can lead to an enlarged heart, and further complicate and worsen your diabetes symptoms.

If you have diabetes, you’re already aware that you have to take special precautions with your blood sugar. But you may not be aware of another, often silent, problem that can go hand-in-hand with diabetes — high blood pressure or hypertension.

Diabetes and High Blood Pressure Risks

The condition occurs in as many as two-thirds of people with diabetes and places these individuals at twice the risk of heart disease than a person only dealing with high blood pressure.

“There’s no doubt that diabetes and high blood pressure are a dangerous duo,” said Betul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic in Ohio. “They’re both very common and are linked by obesity, which is also very common. Nearly half of all people diagnosed with type 2 diabetes have high blood pressure at the time of their diagnosis.”

What Is High Blood Pressure?

Individuals with high blood pressure struggle with blood pumping through their heart and blood vessels with too much force. If this continues for an extended length of time, the high pressure can tire and enlarge the heart muscle.

While readings can vary, most people with diabetes should have a blood pressure of no more than 130/80. The top number is the “systolic pressure,” or the pressure in your arteries when your heart squeezes and fills the vessels with blood. The second number, the “diastolic pressure,” is the pressure when your heart is at rest.

Healthy people should get their blood pressure checked once every two years. That number increases to four times each year for people living with diabetes. Fortunately, there are free blood pressure screenings available through several Canopy Health alliance affiliates, including John Muir Health.

Risk Factors Associated With Diabetes and High Blood Pressure

Why should those with diabetes be aware of the risks of high blood pressure? Type 2 diabetes is caused by resistance to insulin, the hormone your body needs to use blood sugar for energy. Since the bodies of those with type 2 diabetes resist insulin, sugar builds up in their blood.

“That means your body makes even more insulin, and insulin causes your body to retain salt and fluids, which is one way diabetes increases your risk for high blood pressure,” said Dr. Hatipoglu. “Over time, diabetes damages the small blood vessels in your body, causing the walls of the blood vessels to stiffen. This increases pressure, which leads to high blood pressure.”

The combination of high blood pressure and type 2 diabetes can greatly increase your risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease and retinopathy.

Chronic high blood pressure can also contribute to early onset of conditions such as Alzheimer’s disease, dementia, and stroke because the blood vessels in the brain are particularly susceptible to damage due to high blood pressure.

Healthy Tips For Lowering Blood Pressure

Making certain lifestyle changes can not only reduce complications from diabetes but can also greatly reduce your risk of high blood pressure. In fact, lowering your systolic blood pressure by 10 points has been shown to lower all diabetes complication risks by 12 percent overall.

Here are some helpful tips:

  • Regularly visit your primary care physician and take advantage of free blood pressure screenings.
  • The American Heart Association recommends either 150 minutes per week of moderate-intensity exercise, 75 minutes per week of vigorous exercise, or a combination of moderate and vigorous activity each week.
  • Maintain a healthy weight.
  • Limit your salt intake to two grams per day, which is about one teaspoon.
  • Eat a diet with low sugar but plenty of fruits, vegetables, fish, healthy fats, and whole grains.
  • Don’t smoke and drink only in moderation.
  • Avoid nonsteroidal anti-inflammatory drugs (NSAIDs), which can raise blood pressure. Take acetaminophen instead whenever possible.

If you have type 2 diabetes and high blood pressure, these lifestyle changes (along with regularly seeing your physician and having your blood pressure screened) can help you get your diabetes and blood pressure under control. The goal is to live well with diabetes and work to prevent complications, and lowering your blood pressure is a critical step.


American Heart Association Recommendations for Physical Activity in Adults. (2018, April 18).  American Heart Association. Retrieved from https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Cotey, S. (2016, May 23). 6 Best Tips to Lower Blood Pressure When You Have Diabetes. Health Essentials. Retrieved from https://health.clevelandclinic.org/6-best-tips-lower-blood-pressure-diabetes/

Heart-Health Screenings. (2017, June 30).  American Heart Association. Retrieved from https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/heart-health-screenings

Iliades, C. (2013, July 25). Diabetes and High Blood Pressure: How to Manage Both. Everyday Health. Retrieved from https://www.everydayhealth.com/hs/type-2-diabetes/diabetes-and-high-blood-pressure/

The Relationship Between Type 2 Diabetes and High Blood Pressure. (n.d.) Healthline. Retrieved from https://www.healthline.com/health/type-2-diabetes/hypertension