Connection Between Type 2 Diabetes and Hypertension

Individuals with type 2 diabetes need to manage their blood sugar levels closely, keeping them within an optimal range to prevent complications such as heart disease. 

Both the American Diabetes Association (ADA) and the American Heart Association (AHA) report the link between type 2 diabetes and the increased risk of heart conditions like cardiovascular events, coronary artery disease, and stroke.^{1, 2} 

However, many people are not aware of the connection between type 2 diabetes and hypertension (high blood pressure). 

Subsequently, high blood pressure puts individuals at increased risk for heart disease and stroke (the leading causes of death in the United States).³ 

High blood pressure occurs in 50% to 80% of people with type 2 diabetes. It is more common in people with type 2 diabetes, but diabetes is more common in people with high blood pressure than in those without high blood pressure.² 

Research points to a strong connection, but it is unclear which condition caused the other, or perhaps both conditions together. Both blood glucose levels and blood pressure should be monitored in diabetic patients. 

Keep reading to learn about the link between type 2 diabetes and hypertension, how blood pressure is measured, its symptoms, key risk factors, and tips on preventing high blood pressure through diet and exercise. 

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What is High Blood Pressure?

Blood pressure is the pressure of circulating blood pushing against the artery or blood vessel walls. The arteries carry blood from your heart to every part of the body.³ 

High blood pressure increases the risk of heart disease and stroke due to excess pressure on the arteries and body. The Centers for Disease Control and Prevention (CDC) reports that high blood pressure was the primary or contributing cause of 685,875 deaths in 2022.^{2, 3} 

Normal blood pressure is less than 120/80 mmHg in adults. Systolic blood pressure (120) is the force of the blood flow when blood pumps out of your heart. Diastolic pressure (80) is the pressure between heartbeats.^{3, 4}

In adults, high blood pressure is 130 mmHg or higher systolic pressure readings or diastolic readings above 80 mmHg consistently.^{3, 4}

Symptoms due to high blood pressure don’t occur until severe damage has already happened. Checking your blood pressure several times yearly can help you monitor changes and seek treatment sooner.^{3, 4}

High Blood Pressure Symptoms

Hypertension is considered the “silent killer,” as most often, there are no symptoms of high blood pressure until significant damage has already happened. Damage includes heart and artery hardening, kidney disease, stroke, and vision loss.² 

You may have symptoms if your blood pressure is greatly elevated (hypertensive crisis of 180/120 mmHg) of headache, dizziness, and blurred vision.⁴ 

Additionally, high blood pressure symptoms can present similar to other medical conditions and problems, making it hard to identify by symptoms alone.

Remember, 50 to 80% of people with type 2 diabetes have hypertension.² About one-third of American adults are unaware they have high blood pressure and are untreated.⁴ 

Regular blood pressure checks can help you monitor your readings and risk for health problems like kidney disease, heart attack or heart failure, stroke, vascular dementia, alongside type 2 diabetes.⁴  

What is the Link Between Diabetes and Hypertension?

Research continues to establish that type 2 diabetes (and insulin resistance) and hypertension coincide and are due to similar causes and metabolic mechanisms.² 

Shared causes and cardiovascular risk factors include:²

• Obesity (60 to 76% of overweight or obese adults have hypertension).
• Excess visceral fat (fat surrounding the abdominal organs), regardless of body mass index (BMI), increases the risk of hypertension in adults with diabetes.
• Socioeconomic and environmental factors contribute to the low availability of healthful foods and the higher intake of foods high in salt, calories, refined carbohydrates, and fat. 
• Gender (women with type 2 diabetes have a higher incidence of hypertension than men).
• Race (black adults with type 2 diabetes have a higher incidence of hypertension than white adults).
• Increased stiffness of arteries in individuals with diabetes and insulin resistance.
• Inappropriate activation of various blood pressure regulating mechanisms in individuals with insulin resistance, obesity, and diabetes. 
• Excess cellular stress predisposes someone to type 2 diabetes and high blood pressure.
• Systemic inflammation contributes to the development of diabetes from insulin resistance and high blood pressure from stiff arteries.
• New research explores altered gut bacteria as a risk factor for insulin resistance and diabetes-induced high blood pressure. 

Type 2 diabetes and high blood pressure share common causes and risk factors that increase the risk of developing either disease and lead to the faster progression of both conditions.² 

Similar diet and lifestyle changes can improve both high blood pressure and diabetes.

<div class="pro-tip"><strong>Also Read: </strong><a href=blood-sugar-high-blood-pressure>Maintaining Stable Blood Sugar Can Help Reduce the Risk of High Blood Pressure</a></a>.</div>

How to Prevent High Blood Pressure with Diabetes

The following lifestyle and diet factors can help prevent and slow the progression of high blood pressure and type 2 diabetes mellitus. 

To start, adopting dietary approaches to address both conditions include: 

• Eating a heart-healthy, blood-pressure-lowering diet, such as the DASH eating plan. The DASH diet is rich in vegetables, fruits, and whole grains and low in saturated fat, sugar, and sodium. It is a research-based eating plan to lower blood pressure.⁵ 
• Balance your carbohydrate intake with protein, fiber, healthy fats, and vitamins and minerals from the DASH diet. Consider the diabetes plate method for portioning and pairing foods to control blood sugar levels.⁶
  • Fill one-half of your plate with non-starchy vegetables like leafy greens, broccoli, sugar snap peas, or green beans. 
  • Fill one-quarter of your plate with starchy vegetables and grains, such as green peas, sweet potatoes, oatmeal, fruit, or brown rice.
  • Fill the final quarter with lean meat or protein, such as beans, lentils, low-fat dairy, skinless chicken, fish, or eggs.
• Limit sugary foods and drinks and sodium (or salt) rich foods.
• Limited alcohol intake.

Other lifestyle changes that reduce your risk of high blood pressure and type 2 diabetes include:

• Stop smoking or exposure to smoke.
• Aim for a healthy weight with slow, gradual weight loss.
• Add physical activity to achieve 150 minutes weekly of moderate-intensity aerobic exercise (walking, jogging, or swimming).
• Reducing stress with stress management activities like music or deep breathing.
• Getting enough quality sleep.
• Monitoring your blood pressure and blood sugar levels as recommended by your healthcare provider.⁴

These lifestyle factors can help you prevent and manage type 2 diabetes and high blood pressure. Work with your healthcare provider to determine if medicines are also needed to control these two conditions. Possible medications that your healthcare provider could prescribe include:

• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers (ARBs)
• calcium channel blockers
• Diuretics
• Beta-blockers

Learn More About How to Improve Blood Sugar Health With Signos’ Expert Advice

Managing your blood sugar levels and good blood pressure control can help you prevent complications and the progression of both conditions. 

Diet, exercise, and lifestyle changes can help you get back on track with your health. 

Prioritizing your health with a nutritious, balanced diet can improve your health and prevent both type 2 diabetes and high blood pressure.

A continuous glucose monitor (CGM) can help you monitor blood sugar levels while making diet changes, improve your health, and encourage healthier eating habits. 

Learn more about nutrition and healthy habits on Signos’ blog, which is written by nutrition and health experts. Take a quick quiz to determine if Signos fits your needs.

<div class="pro-tip"><strong>Learn More: </strong><a href=low-blood-pressure-fasting>How Intermittent Fasting Can Lead To Lower Blood Pressure</a>.</div>