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Blood Pressure

The Connection Between Diabetes and Hypertension

By Blood Pressure, Health

Living with the chronic disease requires ongoing medical attention and is the leading cause of death and disability in the United States. Diabetes and hypertension are two of these chronic diseases that impact millions of people worldwide. 


Hypertension, which is also known as high blood pressure, is when your average or resting blood pressure is higher than the normal range established by the American Heart Association. Your blood pressure is the amount of pressure that pushes against your artery walls which typically comes from the heart pumping blood. To have hypertension, your blood pressure should be at or higher than 130/80 mmHg per the CDC. 

Common type of diabetes

There are two forms of diabetes, type 1 and type 2 diabetes, which both cause your blood glucose (or blood sugar) to be too high. Type 1 diabetes is usually diagnosed in children and young adults and is a result of your body being unable to make insulin (the hormone needed to allow blood glucose into cells for fuel). Type 2 diabetes is more common and typically diagnosed in middle-aged and older individuals. With type 2 diabetes, your body has the capability of producing insulin but it does not make or use it well. 

The American Diabetes Association provides information about some common methods for diagnosis, including an A1C of greater or equal to 6.5% or a fasting blood sugar level at 126 mg/dl or higher.

If you’ve been diagnosed with or are worried about either of these conditions, in this blog we’re breaking down how they are connected and ways to prevent them. 

How diabetes and blood pressure are connected 

According to a 2012 review published in the Current Atherosclerosis Reports, hypertension occurs in about 30% of individuals who have type 1 diabetes and approximately 50% to 80% in those with type 2 diabetes. Studies have also indicated that only 42% of people with diabetes had normal blood pressure, and only 56% of those with hypertension had normal glucose tolerance (which indicates how your body processes sugar). 

There are several reasons behind why these two conditions are often seen together. Researchers of a 2018 study published in Hypertension concluded that the “development of hypertension and diabetes mellitus track each other over time.” A common feature they notice in both prediabetes and prehypertension is insulin resistance. As we previously mentioned, insulin helps to keep the amount of sugar or glucose in the blood under control. When someone is insulin resistant, which occurs in type 2 diabetes, your body isn’t responding to or making enough insulin to allow glucose to enter the cells. 

Insulin resistance often does not have any symptoms which leads to a gradual increase in blood sugar levels if it’s not being treated. This can cause damage to the blood vessels, eventually making them become thick and stiff (a condition called atherosclerosis). The hardening of these blood vessels increases the pressure that blood is being pumped through. , AKA high blood pressure. The combination of these effects left untreated can lead to serious conditions such as heart attack and stroke.

Diabetes and blood pressure share many risk factors. These include:

  • Family history of these conditions 
  • Having excess weight and body fat 
  • An inactive lifestyle 
  • Stress and poor sleep
  • Tobacco use 
  • Older age 

Can one cause the other? 

The short answer is yes, diabetes can cause hypertension and hypertension can cause diabetes. 

There seem to be two factors that link these conditions together — genetics and environment. According to the same 2012 review, certain DNA sequences that can be used to predict the potential occurrence of diabetes were also linked with predicting the onset of hypertension. However, our lifestyle plays the biggest role in controlling environmental factors impacting our health, which includes diet and physical activity. 

Factors such as inflammation and oxidative stress also occur in both hypertension and diabetes. A 2018 study published in the Journal of Inflammation Research states that as diabetes and hypertension progress, it decreases antioxidant and anti-inflammatory biomarkers which leads to an imbalance in oxidative stress and inflammation.  

Prevention of high blood pressure and diabetes 

Maintaining a healthy lifestyle is key to reducing the risk of chronic diseases, including diabetes and hypertension. High intakes of sodium, alcohol, and saturated fat combined with smoking, lack of physical activity, and mental stress, are all factors that can affect our overall health and longevity. 

The American Heart Association recommends getting at least 150 minutes per week of moderate-intense aerobic activity or 75 minutes per week of vigorous aerobic activity. Moderate-intense activities include: 

  • Brisk walking (at least 2.5 miles per hour) 
  • Water aerobics 
  • Dancing 
  • Gardening 
  • Tennis
  • Biking 

Along with aerobic activity, it’s recommended to add in 2 days of moderate- to high-intensity muscle-strengthening activity like resistance bands or weights. 

When it comes to healthy eating, the Dietary Approaches to Stop Hypertension (DASH) diet, was created specifically to prevent and treat hypertension. An analysis published by the American Heart Association found that the DASH diet is also effective against diabetes. According to the article, the DASH diet significantly improved fasting insulin levels when followed for more than 16 weeks. 

The DASH diet doesn’t require special foods, but it is geared towards a heart-healthy eating style. The plan recommends:

  • Eating vegetables, fruits, and whole grains 
  • Choosing fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils 
  • Limiting foods high in saturated fat including fatty meals, full-fat dairy products, and tropical oils (coconut and palm oils) 
  • Limiting sugar-sweetened beverages and foods 

The diet highly recommends consuming no more than 2,300 milligrams of sodium per day, which is no more than 1 teaspoon. If sodium intake is cut back to 1,500 milligrams, blood pressure could be lowered even more. 

Medication options 

Lifestyle changes are important, but some situations may call for the treatment of medication, as well. According to a 2017 article, published in the Journal of Hypertension, individuals that have a blood pressure that is 160/100 mmHg or higher, should be treated with medication along with lifestyle therapy. It’s also believed that the management of hypertension should be aggressive in those that have diabetes. The treatment for hypertension should include prescriptions that reduce cardiovascular events in those with diabetes. Medications might include: 

  • ACE inhibitors: relax blood vessels and decreasing blood volume 
  • Angiotensin receptor blockers: these block angiotensin, which is a chemical that narrows blood vessels 
  • Thiazide-like diuretics: reduce the fluid that accumulates in the body 
  • Dihydropyridine calcium channel blockers: reduce the entry of calcium into muscle cells 

It’s also not uncommon to be prescribed multiple drugs simultaneously; however, if lifestyle therapy is consistentin some cases, medications can eventually be discontinued. 

The takeaway 

Since diabetes and hypertension have many shared risk factors, those that are diagnosed with one will have a higher chance of developing the other. Prevention and management of these conditions come with lifestyle adjustments which include diet and exercise, but treatment will often include medication(s) based on the severity. If left untreated, the combination of diabetes and hypertension can lead to serious health complications including heart attack, or stroke. 


Lauren Armstrong is a Registered Dietitian with several years of experience counseling and educating individuals seeking chronic disease prevention and a healthier lifestyle. She is a graduate of Western Michigan University and completed her dietetic internship at Michigan State University.

Top 5 Exercises to Manage Hypertension

By Blood Pressure, Fitness

We have all heard about the importance of avoiding high blood pressure — but did you know that there are exercises you can do to reduce your baseline values over time?

While it isn’t something you can tangibly feel, your blood pressure ebbs and flows throughout the day to keep up with your metabolic demands. During periods of physiological stress (like when you exercise or are feeling overwhelmed), your blood pressure can increase for a short period of time — which is not a situation that is considered to be dangerous or unhealthy. But, when a person’s baseline resting blood pressure readings remain high for long periods of time, the risk of developing serious health conditions rises significantly.

But, as scary as a high blood pressure diagnosis can be, it is important to know that high blood pressure is a reversible condition. When you work with your primary care provider and make lifestyle and habit changes, it is possible to lower your baseline daily blood pressure readings to a more healthy and sustainable level.

So, with this in mind, we wanted to explore what you need to understand about high blood pressure, including the most common causes, which values are considered to be healthy readings, how to monitor your blood pressure, and helpful exercises proven to lower blood pressure over time.

Here is everything you need to know about high blood pressure and the exercises you can do to improve it:

What is blood pressure?

As one of the five primary human health vital signs, your blood pressure measures the amount of force exerted on your circulatory system. As a dynamic value, your blood pressure changes throughout the day, depending on activity levels, medical comorbidities, stress, dietary intake, and more.

Unlike your heart rate or temperature, blood pressure is two separate measurements recorded as a single value. Often seen written as a fraction (e.g., 120/80 mmHg), each number gives your primary care provider important information about the function and health of your vascular system:

  • Systolic blood pressure — Written as the top number of the measurement, a person’s systolic blood pressure refers to the amount of force exerted against your blood vessels during a heartbeat. This value represents the highest amount of pressure your arteries, veins, and capillaries are exposed to.
  • Diastolic blood pressure — As the bottom number of the measurement, your diastolic blood pressure value represents the amount of pressure your vascular system is subjected to between heartbeats. In most cases, elevated diastolic blood pressure values are seen in people with high systolic blood pressure.

How high is too high for blood pressure?

According to the Centers for Disease Control and Prevention (CDC), a healthy blood pressure reading is 120/80 mmHg. While it is completely typical for your blood pressure to rise above this level throughout the day, it is advised that your baseline blood pressure (the reading taken when you are at rest) remain as close as possible to these values. In contrast, when a person’s baseline blood pressure levels remain high, they are at an elevated risk of developing serious medical complications. The criteria for the different stages of diagnosis for high blood pressure and hypertension include:

  • Elevated blood pressure — 120-129 mmHg / 80 or less mmHg
  • Stage 1 hypertension — 130-139 mmHg / 80-89 mmHg
  • Stage 2 hypertension — 140 or higher mmHg / 90 or higher mmHg

Prolonged exposure to high blood pressure damages the blood vessels and heart. Because of this, finding ways to manage chronically high blood pressure is essential for reducing your risk of experiencing medical complications, such as a stroke or heart attack.

How to accurately measure your blood pressure

The first step to assessing your baseline blood pressure is taking regular and accurate blood pressure readings — because, without reliable data, it can be challenging to know if you are truly at risk!

Using an automatic blood pressure cuff and monitor at home, you can record your blood pressure readings to determine their baseline values. Because many factors can contribute to an inaccurate blood pressure reading, here are a few of our top tips for avoiding inaccuracy when you take your blood pressure at home:

  • Ensure that you are using the right size of cuff for your arm
  • Maintain a good posture throughout the reading
  • Keep your measuring arm at the height of your heart
  • Avoid taking your blood pressure after exercise or stress
  • Double-check your reading on the opposite arm whenever possible

To determine your baseline blood pressure, performing daily blood pressure readings for at least a few weeks can be beneficial. If possible, take your blood pressure at a similar time of day on each occasion, during a rest period. After each reading, we recommend recording your values in a journal to give to your primary care provider for further analysis.

How activity impacts blood pressure

So, how can exercise (something that causes an acute spike in your blood pressure) reduce your baseline blood pressure readings? The answer lies in the many cardiovascular benefits that regular exercise offers.

Aerobic exercises are any activity that increases your body’s need for oxygen, which is an essential nutrient for the function of your muscle cells. Exercising your muscles during a workout increases your oxygen demand — which explains why it is common for your breathing and heart rate to increase during aerobic activity.

When you participate in this type of exercise, you put your cardiovascular system (the heart, arteries, and veins) under additional stress to keep up with your metabolic needs — which in turn helps to improve your strength and endurance. So, by regularly participating in aerobic exercise, you can decrease your baseline blood pressure, as a stronger heart and vascular system do not need to exert as much force to meet the needs of your cells.

5 exercises that lower blood pressure

If you or someone you love has recently been diagnosed with high blood pressure, it is important to know that it doesn’t have to be a life-long condition. By working closely with your primary care provider and integrating some of the following blood pressure-reducing exercises into your daily routine, you will be amazed to see how quickly your baseline blood pressure can be guided to lower, healthier levels:

  • Riding a bike

As a great outdoor or indoor exercise, cycling has been shown to offer both short and long-term benefits for managing blood pressure. While it is common for your blood pressure to increase while biking, studies have shown that regular cycling can reduce your baseline systolic and diastolic blood pressure over a period of six months.

If you are new to biking or have not participated in regular aerobic exercise in some time, we highly recommend starting slow. As you become more confident and build increased cardiovascular endurance, longer and more regular bike rides will become easier for you to integrate into your fitness routine.

  • Brisk walking

Perfect for those who are new to regular exercise, getting out for a brisk walk has proven to have many positive effects on your health and baseline blood pressure. As a low-impact aerobic exercise, brisk walking has been shown to reduce baseline systolic blood pressure in people who participated in supervised walking sessions over a six-month period.

Start with something as simple as walking around the block at a leisurely pace. Your walking speed and distance can be safely increased over time, based on how well you feel. Whenever possible, walking with a friend or family member can help to encourage continued commitment (and it makes exercising way more fun!)

  • Swimming

Do you enjoy a morning or afternoon swim? If so, you are well on your way to maintaining healthy blood pressure levels. As one of the more demanding aerobic exercises, swimming can help to improve a person’s cardiovascular health while also reducing their baseline systolic blood pressure value over time.

If you are new to swimming, using supportive flotation devices can help to make this exercise safer and more enjoyable. Additionally, due to the sometimes high cardiovascular demands of swimming, be sure to start slow — even swimming a few lengths of a pool regularly can positively affect your health.

  • Dancing

If you love to get funky on the dance floor, you are doing great things for your heart and blood pressure! As a fun and social option for aerobic exercise, all forms of dancing can help to improve cardio endurance and strength, which in turn has been proven to reduce both systolic and diastolic blood pressure readings.

Whether you enjoy line dancing, partner dancing, or dancing alone in your home, choosing to dance regularly is an excellent option for reducing your stress and blood pressure levels. So, the next time you hear your favorite song, be sure to get up and dance!

  • Gardening 

Finally, for all of the green thumbs out there, regular gardening is another form of aerobic exercise that can reduce blood pressure. According to the CDC, gardening (including digging and lifting) is a moderate-intensity exercise that can offer a multitude of health benefits. As an excellent low-impact option for people of all ages, gardening offers more health benefits than most people realize!

As with any other lifestyle change, we highly recommend speaking to your primary care provider before you decide to pick up a new workout routine. Depending on your personal needs, they will be able to provide additional support and encouragement to help ensure that your newfound exercise program is both fun and safe.

The key takeaways

It’s clear that your blood pressure is deeply connected to your cardiac and overall health. While it is typical for your blood pressure levels to fluctuate throughout the day, based on your needs, having chronically high values at your baseline can put you at risk of experiencing serious medical complications. However, there are exercises you can do that are associated with reduced blood pressure readings over time.

With plenty of different aerobic exercises to sample, we hope this article has inspired you to try making one (or more) of these activities a part of your daily routine. Happy exercising!