High blood glucose isn't the only thing people with diabetes (PWDs) must worry about. In recent years, the importance of controlling blood pressure has become apparent. High blood pressure, high blood glucose, and abnormal lipids (good [HDL] and bad [LDL] cholesterol and triglycerides) are a dangerous trio that can speed the development of diabetes complications. Together they damage large blood vessels, causing heart attacks and strokes, and small blood vessels, causing eye and kidney disease.
"I tell my patients with type 2 diabetes that they don't have three or four separate diseases. Treating type 2 is not only treating high blood sugars but also treating all cardiovascular risk factors-cholesterol, obesity, and hypertension," says Joel Zonszein, M.D., director of the Clinical Diabetes Center at Montefiore Medical Center in New York. "Blood glucose, blood pressure, and blood lipids need to be treated aggressively and early in the continuum of diabetes."
Unfortunately, not all people living with diabetes receive close attention to treating high blood pressure. The reasons are many, from "white-coat syndrome" (in which apprehension of being in a medical setting results in a higher-than-expected reading) to a wait-and-see attitude while a person tries to lose weight or exercise more.
"White-coat syndrome should not be an excuse not to treat blood pressure," Zonszein says. "If someone with diabetes has repeat high readings, such as 130/85 mmHg, it is an indication to start medications."
"Cholesterol, glucose, and weight are very important. But controlling blood pressure can provide the greatest value in reducing blood vessel complications," says endocrinologist David Kendall, M.D., of the International Diabetes Center at Park Nicollet in Minneapolis.