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Understanding the Link Between Hypertension and Diabetes

Diabetes

Hypertension and Diabetes: Treatment Goals

Summary & Participants

It's long been known that diabetes often goes hand-in-hand with high blood pressure. But many of the 11 million Americans that have both conditions don't get the treatment they need. Join experts as they discuss why people with diabetes also need to focus on controlling their blood pressure.

Medically Reviewed On: July 01, 2008

Webcast Transcript

MABEL JONG: Hello, and welcome to our webcast. I'm Mabel Jong. For diabetes patients, changes in blood sugar levels can mean the difference between well-being and serious danger, so controlling these levels is a crucial part of daily life. But a large percentage of people with diabetes also develop high blood pressure, or hypertension, which is equally dangerous.

Joining me today to discuss the treatment of hypertension in diabetes patients are Dr. Dominic Sica from the Medical College of Virginia Campus of Virginia Commonwealth University, and also Dr. William White from the University of Connecticut School of Medicine.

If you found out that you have both hypertension and diabetes, what are your treatment goals?

WILLIAM WHITE, MD: When you have both high blood pressure and diabetes, it's kind of like a double whammy, to tell you the truth, because you are now at enhanced risk for coronary disease, vascular disease, kidney disease and so forth. So we've become more aggressive in recent years, because results of large studies suggest normalization is more important than ever before. So we are now trying to shoot for blood pressure that is normal i.e., less than 130 for the systolic pressure, which is the top number, and less than 80. If you have significant renal or kidney disease, we're even looking for lower values than that, if possible i.e., less than 125 or 75.

You've got to do the same thing with blood sugar. You have to keep that under control. We're now looking for blood sugars that are in the normal range. We're now looking for blood sugars that are around 100, 110 mg per cent instead of 125 or 150, like we used to accept in the old days. And in addition to that, we use this test called the glycohemoglobin, or hemoglobin AIc, which kind of looks at the pattern of control of blood sugar for the last two or three months. That's a percentage, and so we look at that now as a value that we're trying to get down to around 6%, if possible.

MABEL JONG: What's the first step in achieving some of those levels?

WILLIAM WHITE, MD: It's going to require the non-drug options such as exercise, diet, watching your salt intake and so forth, but in that case we've learned that you really need to have multiple drugs used in a thoughtful combination so that you can take most of the stuff in the first part of the day or at night, and not having to take medications throughout the day.

MABEL JONG: Now, Dr. Sica, would you agree that you would go right for the medications first, or should you try diet and exercise first?

DOMINIC SICA, MD: You always try it, but it may be simultaneous or first. So even though you may start the medicine, you almost always implement a lifestyle management plan that incorporates into it appropriate dietary modifications and exercise pattern. Those are key issues, so I don't think we separate them.

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