The Specialist Clinics

Hi!

I am Dr. Vishal Garg, Senior Consultant Physician. Today I am going to discuss the importance of measuring blood pressure in patients with diabetes. The patients with diabetes who are having high blood pressure as compared to the patients who are having normal blood pressure are more prone for the complications or for the early complications like Coronary Artery Diseases, Cerebrovascular Accidents, Peripheral Vascular Diseases, Diabetic Kidney Disease, Diabetic Eye Diseases. How does diabetes cause damage to the arteries? Diabetes basically accelerates the process of hardening of the arteries called as Atherosclerosis and thus increasing the pressure which is called blood pressure. So guys what is normal bloodpressure? What is blood pressure? Blood pressure is basically consisting of two components, Systolic blood pressure and Diastolic blood pressure. Systolic blood pressure is the component which is on the topmost part of the blood pressure. It is basically the blood pressure in the arteries when the heart is squeezing the blood and filling the arteries.

While Diastolic blood pressure or the lower component of the BP is that which is there in the arteries when the heart is relaxing between the two beats. A normal blood pressure is usually considered to be around 130/80 in a patient with diabetes. Many patients ask us what are the symptoms of high blood pressure doctor? I think I don’t have blood pressure. But on regular monitoring, they are found to have high blood pressure. So friends usually there are no specific symptoms of high blood pressure. That’s why it remains undetected. Usually, if the patient is having very high blood pressure, it may cause headache, giddiness and other symptoms. But otherwise, there will not be any symptom. So the most important thing is regular monitoring of the blood pressure by your clinician. The next thing comes to our mind or to the patient’s mind is what can I do to keep my blood pressure under control? Yes, you can do a lot. The most important thing is lifestyle modification.

Lifestyle modification is very important part or the integral part of the management of diabetes and hypertension. What are the components of lifestyle modification? The first component is diet. You have to control your diet habits. You have to have a balanced diet so that your sugars will remain under control. Secondly, the patient should not eat extra salt, or I will say avoid the table salt. I will never advice any patient to avoid salt completely because that can lead to a condition called Hyponatremia. Next, is the exercise. Exercise is the very important part. Every patient should do exercise, should do a regular walk or a jog in the morning at least for 30 minutes , 5 days a week is very very important. The third thing is your habits, smoking and alcohol. If possible quit smoking, quit alcohol totally. My few patients were insisting that they will not be able to leave totally, so I tell them to take a very low amount of quantity of alcohol may be once or twice a week.

Next thing is control of blood sugar. Blood sugar’s control is very important. It will help in managing diabetes and if the diabetes is under control then the process of hardening of arteries which I discussed earlier will be slower and hence patient will not have high blood pressure early in life. The next thing is Obesity that is very important. If you are having obesity, then you have to loose weight to manage your blood pressure. Now how to say that you are having obesity or not? You have to check your BMI, Body Mass Index, which is very easy. You can check by dividing your weight in kilogram in heights meter square, that will give you BMI. If your BMI is more than 25, then you definitely need to loose weight. Loosing weight will help you in both controlling blood pressure and sugars. After that, if you do all these lifestyle modifications and BP is still high, then comes the rules of the medicines Pharmacotherapy, that your doctor will help you in managing your blood pressure. The most common... there are multiple drugs available to control blood pressure. The most common which I am using in a patient with diabetes is the ACE inhibitors or the ARBs as they also help to maintain or delay the progression of the diabetic complications like diabetic kidney disease. So my advice to all of you will be that you have to monitor your blood pressure regularly and you have to visit your clinician regularly as per his advice and keep yourself updated about the development of BP in the patients with diabetes.

Thank you.