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Tips to Lower Blood Pressure

Do you have diabetes and high blood pressure? Here are a few practical lifestyle changes to make to help you control your blood pressure -- and benefit your diabetes, too.

How to Reduce Your Blood Pressure

High blood pressure, like high blood glucose (also known as blood sugar), is a medical condition that you can dramatically improve by putting a few lifestyle changes into action. With these actions, such as eating less restaurant and processed foods, and walking for 30 minutes most days, you can lower and control your blood pressure.

· Normal blood pressure: < 120/80 mmHg

· Blood pressure goal for people with diabetes: <140/80 mmHg (based on 2014 American Diabetes Association recommendations)

"Research repeatedly shows that making one or more healthy lifestyle changes, from eating more fruits and vegetables to walking more, can help lower blood pressure," says Eva Obarzanek, Ph.D., MPH, RD, former research nutritionist at the National Heart, Lung, and Blood Institute. "Any movement of mercury downward, even a few points, improves your odds of staying healthy."

Choose one or more of the following steps to start lowering your blood pressure if it’s too high. Bonus: Many of these actions can improve your blood sugar, cholesterol, and triglycerides, too. That’s because at the core of all of these problems is insulin resistance. If you can take lifestyle steps to help your body become more sensitive to the insulin it does make, you’ll better protect your overall health. 

Quit Smoking

Quitting smoking is the first step on this list because health experts agree that it's one of the most impactful lifestyle changes to make. Recently several studies have pointed to a role of smoking in the development of type 2 diabetes.

Smoking tobacco does not directly cause high blood pressure, but it can escalate the risk of heart and blood vessel diseases. Studies show that people with diabetes who smoke have an equal or greater risk of cardiovascular disease, premature death, and an increase in the incidence of the complications of diabetes, which affect the small blood vessels and contribute to eye, kidney, and nerve damage. 

You'll likely need to make a number of attempts to quit before you are able to stop smoking for good. There’s a lot of support available to assist you in your effort. Ask your health care providers if they can direct you to some help. If they don’t have suggestions, connect with the American Lung Association or American Cancer Society. These two organizations have resources to help you quit smoking.

An old adage is pertinent when it comes to quitting smoking: If at first you don’t succeed, try, try, again!

Action Tip: Write out a smoking-cessation plan that you believe will work for you. A multi-step approach is more likely to succeed. For example, participate in a smoking-cessation program; find a new, healthier habit (taking a walk around the block or doing a short meditation) when you crave a cigarette; and get a prescription for a medication that can help you wean off nicotine.

Visit smokefree.gov today.

Lose a Few Pounds

"If a person is overweight, losing even 10 pounds can lower blood pressure if it's elevated and is as effective as taking one blood pressure medicine," says nutrition consultant Marion J. Franz, R.D., CDE, a Diabetic Living editorial advisory board member. Losing weight soon after you have been diagnosed with diabetes can also bring other benefits related to increasing insulin sensitivity, such as lowering blood sugar and improving cholesterol.

Action Tip: Cut your calories by trimming your portions. You might also try to cut down on sugary drinks and sweets -- items that contain a lot of added sugars. Bonus: If you eat at least 2-1/2 cups of both fruits and vegetables a day, you’ll eat more potassium. Most Americans don’t get enough, and eating more potassium can help lower blood pressure.

Cut Your Sodium Intake

Most Americans eat too much sodium. According to the U.S. Centers for Disease Control and Prevention, about 1 in 3 American adults has high blood pressure. The largest percent of our sodium consumption -- about three-fourths -- comes from restaurant and processed foods and not the occasional high-sodium foods like potato chips, pickles, and olives. It’s more likely that the frequent consumption of what the American Heart Association calls the Salty Six -- breads/rolls, cold cuts/cured meats, pizza, poultry, soups, and sandwiches -- are what contribute to high sodium intake. 

On average Americans consume about 3,400 milligrams of sodium each day. That's more than double the 1,500 milligrams recommended for people with diabetes and high blood pressure. "Don't let the tough-to-hit 1,500 milligram mark discourage you. Any sodium reduction can help lower your blood pressure," says Jackie Boucher, RD, LD, CDE, vice president for education of the Minneapolis Heart Institute Foundation.

"I steer clear of store-bought salad dressing, cold cuts or deli meat, and canned soup," says Juanita Noid, PWD type 2, of Oxford, Georgia. When reading nutrition labels, follow what the U.S. Food and Drug Administration (FDA) defines as healthy for sodium consumption -- no more than 800 milligrams for entrees and 480 milligrams for sides.

A processed food's total sodium content includes the sodium in the food or ingredient itself along with the other sodium-containing ingredients, such as baking soda (sodium bicarbonate), preservatives (such as sodium metabisulphite), and flavor enhancers (such as MSG, or monosodium glutamate).

Action Tip: Choose and use fewer processed foods. When it comes to vegetables, try to use fresh or frozen with no sauces. These forms contain next to no sodium. If you use canned vegetables, drain and rinse them.

Use Less Salt

Salt is not the same as sodium, though it contains sodium. Salt is sodium chloride: about 40 percent sodium and 60 percent chloride. Just 1/4 teaspoon of salt contains 575 milligrams of sodium. It’s important to limit both sodium and salt.

Sodium causes the body to hold fluid and raise blood pressure. Some people are salt-sensitive, especially adults who are older than 50, African-American, or have high blood pressure or diabetes. Research from the National Institutes of Health-funded DASH study (Dietary Approaches to Stop Hypertension), a large and influential study that looked at dietary approaches to lower blood pressure, showed that salt-sensitive people with high blood pressure had an even greater decrease in their blood pressure when they followed the DASH eating plan. 

What we eat daily:
• Most Americans consume 3,400 mg sodium

Daily sodium targets:
• Most adults without high blood pressure: 2,300 mg (this is the amount manufacturers use to calculate the percent of daily value shown on food labels)
• People with high blood pressure, people with diabetes, African-American adults, and adults age 50 and older: 1,500 mg

Action Tip: Don’t use salt in cooking, and remove the saltshaker from your table. "Add flavor to foods with a variety of herbs, spices, freshly ground black pepper, lemon and lime, mustards, and vinegars instead of salt," says Jackie Boucher, RD, LD, CDE. These tasty seasonings pack on the flavor without adding sodium. 

Eat More Fruits and Vegetables

The NIH-sponsored DASH study and the related PREMIER study showed that eating a sufficient amount of fresh fruits and vegetables every day, along with other potassium-rich foods, can help people with high blood pressure to lower it. The potassium -- and possibly other nutrients contained in fresh fruits and vegetables -- could be the main cause. Adequate potassium can blunt the effect of consuming too much sodium. Americans tend to fall short of the recommended daily 4,700 milligrams of potassium.

Action Tip: Incorporate 2-1/2 cups each of vegetables (especially high-potassium broccoli, spinach, and tomatoes) and fruit (especially high-potassium oranges, cantaloupe, and bananas) into your daily eating plan. 

Treat Your Sleep Apnea

This sleep disorder, very common among people with type 2 diabetes and prediabetes, causes a person to stop breathing briefly but repeatedly while asleep. This condition can add to the reasons for developing high blood pressure. "Studies show that about 50 percent of people with type 2 diabetes have sleep apnea," says Virginia Zamudio Lange, R.N., CDE, a past president of the American Association of Diabetes Educators.

Signs include snoring and/or being tired or drifting off during wake time. If you suspect you have sleep apnea, speak to your health care providers about what you need to do to be tested and diagnosed. If you are diagnosed with it, treat it. Many people with sleep apnea use a continuous positive airway pressure (CPAP) machine. This is a small machine that goes beside your bed. It attaches to a mask that goes over your mouth and nose.

Proper treatment of sleep apnea can lower blood pressure and improve other health parameters, such as blood sugar levels.

Action Tip: To know if you have sleep apnea, talk to your health care provider about getting properly diagnosed. You may be advised to undergo a sleep study.

Drink Alcohol in Moderation

"Adults with diabetes can drink alcohol and should follow the same guidelines as the general public -- an average of up to one drink per day for women and up to two drinks per day for men. People with diabetes should consume no more than three or four drinks in any single day for women and men, respectively,” says Marion Franz, R.D., LD, CDE. When people consume more than three drinks a day, it can raise their blood pressure and make blood glucose management a challenge. As heavy drinkers begin to drink less, their blood pressure can decrease.

Action Tip: If you are at a social gathering or restaurant where alcohol is served, keep a glass of a hydrating, zero-calorie beverage by your side. Try water, club soda, sparkling water, diet tonic water, or a diet soft drink. Quench your thirst with the noncaloric drink and slowly sip your alcoholic drink.  

Choose Fat-Free or Low-Fat Dairy Foods

Another source of potassium is dairy foods, particularly milk and yogurt. People in the DASH and related PREMIER studies consumed two to three servings of low-fat or fat-free dairy foods each day. Dairy foods are also high in calcium, which might play a role in blood pressure control. Most American adults consume barely one serving of dairy foods a day, where most adults are encouraged to consume at least two servings a day. This discrepancy leads to an insufficient intake of potassium and calcium as well as other important nutrients. According to the U.S. Department of Agriculture’s MyPlate recommendations, one serving of dairy equals 1 cup of milk, 1 cup of yogurt, 1.5 ounces of hard cheese, or 1/2 cup of shredded cheese.

Action Tip: Drink more low-fat or fat-free milk. Try fat-free milk on hot or cold whole grain cereal, yogurt with lunch, calcium-fortified fruit juice in moderation, or 1.5 ounces of reduced-fat cheese on a sandwich. If you can’t tolerate dairy foods due to a lactose intolerance, try unsweetened almond milk as an alternative. Almond milk provides calcium, and depending on the brand, the calories can be lower than low-fat or fat-free milk; but it may contain less potassium. Read the nutrition facts label to determine the best product for your nutritional needs. 

Get Physical Activity

Regular exercise makes your heart stronger, which means the heart pumps more blood with less effort and force on your arteries. "Engaging in regular moderate-intensity exercise, such as brisk walking, for at least 30 minutes most days can reduce systolic blood pressure by 4-9 mmHg," says Jackie Boucher, RD, LD, CDE.

Increasing physical activity can also improve blood sugar and cholesterol levels as well as aid in weight loss and boost energy.

Action Tip: Start slowly by adding just a few minutes of physical activity a day. Try walking. For most people, it’s the easiest activity to do and integrate into your lifestyle. Soon enough, 30 minutes of daily movement can become a habit. Wear a pedometer if you want to keep track of your daily steps. Research shows it's also OK to do shorter 10-minute bursts of movement that add up to 30 minutes per day.

Tips to Lower & Control Blood Sugar

Good blood sugar control is vital to diabetes management. Eating healthier, exercising, managing stress, and taking blood glucose-lowering medications if necessary are all components to controlling blood sugar. We give you tips to get you started on the path to better diabetes health.

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