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Thursday, November 7, 2013
High Blood Pressure
High Blood Pressure, Diabetes, and Exercise
I am a 59 year-old white male with diabetes and high blood pressure. I would like to know, for someone with high blood pressure and diabetes, what is the normal reading in numbers? What would be considered too high and what would be considered too low? If it is too high, how do you lower it and if it is too low, how do you make it higher? Is it all right to exercise with high blood pressure and diabetes? Thank you for your time.
The current guidelines define a normal blood pressure as 120/80 or lower, and any blood pressure over 140/90 as hypertension. However, the guidelines also say that diabetic patients should not have a blood pressure over 130/80, and that they should be treated if the level is 130/80 or higher.
Exercise is recommended for every person, and especially for diabetics. Exercise can actually improve blood pressure and blood glucose control.
If a diabetic has a blood pressure of 130/80 or higher, drug therapy should be started. The best antihypertensive drugs for diabetics are ACE inhibitors and angiotensin receptor blockers. These agents are well tolerated and have been shown to reduce cardiovascular disease in diabetic patients.
As long as a person feels well and does not get lightheaded or dizzy, there is no need to increase the blood pressure, even if it is below 120/80. In general, "the lower, the better".
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati