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BLOOD PRESSURE AND PEOPLE WITH DIABETES

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GP measuring BP in T2DM
The available scientific evidence indicates that with respect to blood pressure, people with diabetes have similar levels of risk of developing cardiovascular disease as older adults in the general population. Therefore, in general, people with diabetes are also advised to keep their blood pressure below 140/90 mmHg (millimetres of mercury) like those without diabetes. However, people with diabetes that have albuminuria/proteinuria should aim for blood pressure less than 130/80 mmHg. Lower blood pressure targets may also be recommended for younger people with diabetes and for secondary prevention in those at high risk of stroke.
People with diabetes that have blood pressure readings consistently higher than 130/80 mmHg may need to take blood pressure lowering medication and should discuss the options with their Medical Doctor. As always, treatment targets should be individualised and monitored for side effects from drugs used to lower blood pressure.
From a lifestyle perspective, people with diabetes who consistently have blood pressure readings higher than 120/80 mmHg can aim to:
  • lose a moderate amount of weight (3-7% of initial body weight; e.g., 3 – 7 kg for a 100 kg adult); 1 kg weight loss leads to a reduction in SDP and DBP of ~1 mm Hg.
  • reduce the amount of sodium they consume,
  • increase the amount of potassium they consume,
  • moderate their alcohol consumption (i.e., no more than 1 or 2 Standard drinks a day), and
  • increase their physical activity
In addition to these well-known lifestyle recommendations, there is also some evidence from systematic reviews of randomised controlled trials (RCTs) that carbohydrate quality has an effect on blood pressure in people with diabetes. In 9 RCTs including more than 900 people, there was a dose-response relationship between dietary glycemic index (GI) and systolic blood pressure. That is, the higher the average GI of the diet, the higher the systolic blood pressure level.
Therefore, as well as following the usual lifestyle recommendations for the management of blood pressure, there’s good evidence that consuming a low GI diet will have additional benefits for people with diabetes.
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Dr Alan Barclay, PhD, is a consultant dietitian and chef with a particular interest in carbohydrates and diabetes. He is author of Reversing Diabetes (Murdoch Books), and co-author of 40 scientific publications, The Good Carbs Cookbook (Murdoch Books), Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment Publishing).

Contact: Follow him on Twitter, LinkedIn or check out his website.
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