High Blood Pressure Needs Type 2 Diabetes Management
Posted on January 9, 2012 by Lu Young RN
Making the changes necessary for good blood pressure control are not easy. High blood pressure needs a type 2 diabetes management program of proper diet, exercise, and medications. And if you are like most of us, these changes take time.
High blood pressure is especially damaging for people with diabetes, raising their risk of stroke, coronary artery disease, kidney failure, vision loss and amputations. Both the American Diabetes Association (ADA) and the National Institutes of Health recommend a lower blood pressure target for patients with diabetes than for the general public, urging them to keep their pressures below 130/80 mmHg.
Two out of three adults with diabetes, however, never reach that goal. Many patients are hampered by limited access to health care. Others are delayed by what the authors call “clinical inertia,” a disinclination by patients to implement lifestyle changes or reluctance by their doctors to push additional medications. Among those who are prescribed blood pressure drugs, at least 20 percent of patients with diabetes do not stick to their treatments.
Given time to learn how, many patients would prefer to control blood pressure through diet and exercise rather than with antihypertensive medications. Most guidelines, however, including those of the ADA, recommend at most a three-month trial of medication-free lifestyle therapy for patients with moderately elevated blood pressure. They call for immediate initiation of medication for those with blood pressure more than 10mmHg above the goal.
That is often not enough time for patients to learn the methods, develop good habits and demonstrate improvements.
“We ask patients with diabetes to do a billion things,” Laiteerapong said, “to test their blood sugars, to count carbohydrates, to spend 30 minutes a day doing exercise, including cardio and weight training. Most, if not all, of this is new to them. They need time to adapt. It’s important to do this right, but our results say it’s not that important to do it so fast.”
This study argues that caregivers should work with patients to help them gain the knowledge and develop the necessary skills gradually rather than rushing to drug treatment, especially if their blood pressure is only mildly elevated. It suggests that patients and providers “have more time,” the authors write, “at least up to one year, to focus on diabetes self-management and lifestyle modification.”
More about this subject at the source of this post.
The study mentioned in the post is very good, but does not talk about life expectancy with complications that can occur with high blood pressure such as stroke and heart attack. According to the article, you will 5 months longer if you make the changes sooner rather than later. Frankly, I do not think it takes other factors into account such as high blood pressure’s effect on kidney failure which is common in diabetes.
I think that you should make the changes necessary to bring your blood pressure under control sooner rather than later with a type 2 diabetes management program like the one I outlined at the beginning of the article.
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