Experts recommend that lifestyle changes should be added to medication therapy when people with diabetes try to reduce their blood pressure. These changes include reduction of salt intake, weight loss, and moderately intense physical activity, like brisk walking for 30 to 45 minutes most days of the week. A study in 2002 found that 19.3 million American adults had diabetes, and it is estimated that a third of these adults are undiagnosed. Risk factors for diabetes include advancing age, obesity or being overweight, a family history of type 2 diabetes, and being a member of a minority population at increased risk. African-Americans, Hispanics, Pacific Islanders, American Indians, Alaska natives, and Asians are at higher risk for type 2 diabetes. It is estimated that an additional 26% of the US adult population has "pre-diabetes" and modification of some risk factors, like weight or sedentary lifestyle, may help these adults avoid development of diabetes. The American Diabetes Association recommends that people have a fasting plasma glucose test for an initial screening test. A positive test is determined by a level of blood glucose of greater than 126 mg/dL. If you have a positive fasting glucose test, your doctor may want to confirm it on a separate day with a repeat test. If your test results are "borderline" you may also want to have the test repeated on a separate occasion.There are several different screening tests to determine if you are at risk of diabetes or if you have diabetes. Each test has different advantages and disadvantages. If you have hypertension, your doctor should screen you for glucose intolerance or type 2 diabetes. There is adequate evidence that people with blood pressure above 135/80 mm Hg who have diabetes discovered through a screening program will benefit from the strict blood pressure control strategies indicated for diabetic patients to reduce coronary heart disease.
The available evidence suggests that all adults with high blood pressure readings that are consistently greater than 135/80 mm Hg benefit from tighter control of risk factors associated with diabetes for prevention of coronary heart disease.