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High Blood Pressure

Side effects of lowering high blood pressure

12/22/2008

Question:

My fater is 65 years old and he has had hypertension since he was an adolescent. About fifteen years ago he also developed diabetes. From what I have read the diabetes may be a consequence of the hypertension. About six months ago he had a stroke that paralized his right side. He has regained his speech and he can now walk and move his arm, but he has not recuperated full motion in his right arm and leg. He is carefully monitoring his glucose and blood pressure levels. In the last 3 months he has experienced swelling of the right arm and leg, and he feels lethargic. He thinks that this is due to the lowering of his blood pressure. Is it possible that for someone who has lived with hypertension for a long time the system adapts to the high blood pressure in a way such that when it is low it causes problems? Could the swelling and even the stroke be consequences of lowering the blood pressure?

Answer:

High blood pressure does not cause diabetes, but diabetes causes vascular disease, and many diabetics are also hypertensive.  Unless your father's blood pressure was lowered too quickly, controlling the blood pressure should do no harm.  On the contrary, patients with diabetes and a history of stroke should have their blood pressure treated aggressively, probably to a level of about 120/80.

It is also unlikely that the swelling in your father's right arm and leg are due to the treatment of his blood pressure.  It is more likely due to diabetic neuropathy or a problem with his venous circulation.

In summary, the best protection against another stroke is good blood pressure control.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati