The Relationship Between Hypertension And Diabetes

Diabetes and high blood pressure are closely related diseases. They occur together so frequently that they are officially considered to be “comorbidities” (diseases likely to be present in the same patient). Unfortunately, diabetes makes high blood pressure more difficult to treat, and high blood pressure makes diabetes even more dangerous.

How Are Diabetes and Hypertension Related?

Diabetes and high blood pressure tend to occur together because they share certain physiological traits –- that is, the effects caused by each disease tend to make the other disease more likely to occur.

In the case of diabetes and high blood pressure, these effects include:

• Increased Fluid Volume -- Diabetes increases the total amount of fluid in the body, which tends to raise blood pressure.
• Increased Arterial Stiffness -- Diabetes can decrease the ability of the blood vessels to stretch, increasing average blood pressure.

• Impaired Insulin Handling -- Changes in the way the body produces and handles insulin can directly cause increases in blood pressure.

Although these common biological traits partially explain why diabetes and high blood pressure are such a common pair, in many cases, the two diseases are likely to occur together simply because they share a common set of risk factors. Some important shared risk factors are:

• Body Mass -- Being overweight significantly increases the risk of both diabetes and high blood pressure.
• Diet -- High fat diets rich in salt and processed sugars are known to contribute to the development of organ problems that can lead to both diabetes and high blood pressure.
• Activity Level -- A low level of physical activity makes insulin less effective (which can lead to diabetes) and can contribute to the development of stiff blood vessels, increasing the risk of high blood pressure.

Preventive strategies for both high blood pressure and diabetes usually focus on these specific risk factors.

• How Common is Hypertension in People with Diabetes?

  Data from one large, widely referenced study on type 1 diabetes showed:
  • 5 percent of patients have high blood pressure within 10 years
  • 3 percent have high blood pressure within 20 years
  • 70 percent have high blood pressure by age 40
  In studies of type 2 diabetes, data has shown that almost 75 percent of patients with kidney problems (a common complication) had high blood pressure. In those with type 2 diabetes but no kidney problems, the rate of high blood pressure was about 40 percent. 
• Overall, when averaged across diabetes type and age range, about 35 percent of all people with diabetes have high blood pressure.

Original Article:     Relationship Between Hypertension And Diabetes

Are You At Risk For Hypertension?

What is high blood pressure? 

Blood pressure is a measurement of the force of blood pushing against the walls of your blood vessels. If you have high blood pressure, also known as hypertension, the pressure in your arteries is too high. Blood pressure measurements are written as two numbers – 110/70 mm Hg or 150/95 mm Hg. The top number is known as the systolic blood pressure, or the blood pressure in your arteries when your heart is contracting.

The bottom number is the diastolic blood pressure, or the pressure in your heart as it fills with blood, between contractions. Normal blood pressure is below 120/80 mm Hg. Systolic blood pressure greater than 140/90 mm Hg is considered “hypertension” and all the values that fall in between, from 120 mm Hg to 139 mm Hg systolic and from 80 mm Hg to 89 mm Hg diastolic, are considered “prehypertension.

Except for pregnancy, treatment of hypertension is the most common reason for adults to visit their doctor’s office in the United States.

A recent survey, the National Health and Nutrition Examination Survey (2005-2008), estimates that up to 31 percent of American adults have hypertension. Most people over the age of 65 have hypertension, so the prevalence of high blood pressure in the US is likely to increase as the population ages.Of the approximately 78 million Americans with hypertension, only about 50% have their blood pressure well controlled. Blood pressure control is important, since high blood pressure over a period of time can damage organs, including the kidneys, heart, and brain.

Blood Pressure is a significant predictor of the risk of cardiovascular (heart) disease

In patient over the age of 50, the systolic blood pressure is a better predictor of risk. In younger patients, the bottom number, or diastolic blood pressure, is a better predictor of risk of heart disease than the systolic number.With the widespread availability of well-priced automatic blood pressure cuffs, more people diagnose their high blood pressure at home.

If your average reading is 130/80 mm Hg or above over a 24-hour period, you have hypertension. A daytime average of 135/85 mm Hg or above or a nighttime average of 120/79 mm Hg or above also meets the ambulatory blood pressure monitoring criteria for hypertension. Daytime readings that repeatedly average more than 135/85 mm Hg should prompt you to visit your healthcare provider.

There are several risk factors associated with developing primary hypertension, the most common type of high blood pressure. Advancing age, obesity, family history, and black race are all associated with increased risk of developing high blood pressure. 

Other risk factors for high blood pressure include diabetes, high cholesterol, physical inactivity, and excessive alcohol consumption. 

There are personality traits associated with a higher risk of developing hypertension, including depression, hostility, and impatience. 

Vitamin D deficiency has also been identified as a risk factor for hypertension. 

Smoking raises blood pressure,  just one more reason to quit.

Sometimes, hypertension results from secondary causes, such as use of certain medications. 

Oral contraceptives, especially those with higher doses of estrogen, can raise blood pressure in some patients. 

Nonsteroidal anti-inflammatory drugs, including ibuprofen (Motrin) and Naprosyn, can increase blood pressure, so it’s wise to monitor your blood pressure if you have been on these medications for a prolonged period of time. 

Stimulant medications, including some taken for weight loss, are one cause of hypertension. 

Decongestants, including pseudoephedrine (Sudafed), will raise blood pressure, and if you have hypertension, use of decongestants should be avoided. 

Glucocorticoid drugs, like prednisone, will increase your blood pressure and have a multitude of other potential side effects.

Some people may have high blood pressure as a result of another disease or health condition. 

Renovascular hypertension refers to narrowing or blockage in the arteries that supply the kidney. This results in water and salt retention and increased blood pressure. 

Other common diseases that result in hypertension include obstructive sleep apnea, kidney disease, hyperthyroidism, hyperparathyroidism, Cushing’s syndrome, and primary hyperaldosteronism.

The only way to determine whether or not you have high blood pressure is to measureyour blood pressure. High blood pressure rarely causes symptoms, but it will harm your organs over time. Have your blood pressure checked today!

Original Article:     High Blood Pressure

7 STEPS TO REDUCE STROKE RISK

By BILL GOTTLIEB

A man's last years ought to be spent strapped to the fighting chair of a game-fisher while battling a black marlin, not tethered to a nursing-home bed, incontinent and unable to talk.

But the latter is a likely scenario if you're one of approximately 600,000 Americans who will have a stroke this year.

"Your chance of dying is 20 percent-but you have a 40 percent chance of being disabled and a 25 percent chance of being severely disabled," says Dr. David Spence, director of the stroke-prevention center at the Robarts Research Institute in Canada.

An ischemic stroke—the kind that affects most men—occurs when an artery to the brain is blocked by arterial plaque that has broken loose and caused a blood clot. In fact, it's just like a heart attack, only instead of heart cells dying for lack of blood, brain cells are kicking off-thousands of brain cells. Perhaps paralyzing half of your body. Or slurring your speech. Or plunging you into senility.

But a "brain attack" is not inevitable.

"Fifty to 80 percent of strokes can be prevented," says Dr. David Wiebers, a professor of neurology at the Mayo Clinic and author of Stroke-Free for Life. "Making the simple choices at 25, 35, or 45 years of age can make an enormous difference in preventing stroke when you're in your 60s, 70s, or 80s."

Swallow Nature's Blood Thinner

Loma Linda University researchers found that men who drank five or more 8-ounce glasses of water daily cut their stroke risk by 53 percent compared with guys who drank fewer than three glasses. Water helps to thin the blood, which in turn makes it less likely to form clots, explains Jackie Chan, Dr.P.H., the lead study author.

But don't chug your extra H2O all at once.

"You need to drink water throughout the day to keep your blood thin, starting with a glass or two in the morning," adds Dr. Chan.

Swig Less Soda

Unless it's the diet stuff. The Loma Linda University researchers also discovered that the men who drank large quantities of fluids other than water actually had a higher risk of stroke—46 percent higher.

One theory is that sugary drinks like soda draw water out of the bloodstream, thickening the blood. Another explanation may be the boost in triglycerides caused by sipping liquid sugar.

"Elevated levels of triglycerides-any level above 150-are a risk factor for arterial disease," says Dr. Daniel Fisher, an assistant professor at the New York University School of Medicine.

Count to 3

You may have just lowered your stroke risk.

In a study published in the journal Stroke, researchers noted that of 2,100 men, the anxious guys were three times more likely to have a fatal ischemic stroke than the more serene men. "

Anxiety causes chronic overproduction of dopamine, a neurotransmitter that regulates the brain's control of circulation," says Ernest Friedman, M.D., a professor of psychiatry at Case Western Reserve University.

Counting to three—or reining in your racing mind in any other way—helps by stabilizing your levels of serotonin, the antidote to excess dopamine, says Dr. Friedman.

Hold Your Breath

At least when you're around a smoker. University of Auckland researchers found that people exposed to secondhand smoke are 82 percent more likely to suffer a stroke than those who never inhale. It seems that carbon monoxide promotes clot formation by interfering with nitric oxide, a biochemical that relaxes blood vessels.

"To get rid of every single bit of carbon monoxide after a night at the bar, you'd have to breathe fresh air for about 8 hours. But most of the carbon monoxide will be gone from your body in the first hour," says Laurence Fechter, Ph.D., a professor of toxicology at the University of Oklahoma.

So on your way home, make sure you roll down the car windows and start sucking in some clean air.

Beat Homocysteine

Research suggests that people with high blood levels of this amino acid are more likely to stroke out than those with low readings. Extra folate will help reduce the risk, but only for some people. "Fifty to 60 percent won't respond with lower homocysteine," says Dr. Seth J. Baum, medical director of the Mind/Body Medical Institute, a Harvard affiliate.

Dr. Baum recommends 1,000 micrograms (mcg) of folate, plus 25 milligrams (mg) of vitamin B6, 1,000 mcg of B12, and 1,800 mg of the amino acid N-acetyl-cysteine (NAC). "With folate, B6, B12, and NAC supplements, almost everyone will have normal homocysteine levels," says Dr. Baum.

Pick Up an Iron Supplement

Aerobic exercise is antistroke medicine. Can't run or cycle to save your life? Then lift. "Regular resistance training decreases blood pressure, elevates HDL cholesterol, lowers LDL cholesterol, and decreases the stickiness of the blood," says Dr. Jerry Judd Pryde, a physiatrist at Cedars-Sinai Hospital in Los Angeles.

If you don't already weight-train, try the American Heart Association program: Lift weights two or three times a week, targeting the major muscle groups. For each of the following, choose a weight you can lift eight to 12 times at most, and do one set to fatigue: bench press, shoulder press, lying triceps extension, biceps curl, seated row, lat pulldown, crunch, squat, Romanian deadlift, and calf raise.