Can Diabetes Cause High Blood Pressure?

Diabetes and high blood pressure (hypertension) often occur together. A person with diabetes is twice as likely to have high blood pressure as someone who does not have diabetes.

When you have diabetes, high blood sugar can damage your blood vessels and the nerves that help your heart pump. Similarly, high blood pressure can create increased strain on your heart and blood vessels. When these two conditions occur together, they increase the risk of heart disease (cardiovascular disease) and stroke.

This article looks at diabetes and its relationship to high blood pressure. It also discusses some of the ways these two conditions can be treated and prevented.

Person having their blood pressure taken

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Hypertension and Diabetes

Diabetes and high blood pressure can be comorbid conditions. This means they occur at the same time or one after the other.

Nearly one in three American adults has high blood pressure. Two out of every three people with diabetes have high blood pressure or take prescription medications to lower their blood pressure. Adults with diabetes are nearly twice as likely to die from heart disease or stroke as people who do not have diabetes.

Researchers believe diabetes and high blood pressure could have some potential causes and risk factors in common. For example, both conditions have been linked to:

Diabetes May Contribute To Hypertension

Elevated blood sugar stresses the blood vessels. Damage to the vessels causes them to narrow and accumulate plaque. Plaque is composed of different substances like cholesterol, fats, and waste products. Plaque buildup narrows the vessels even more and forces the heart to work harder to pump blood.

When the heart has to work harder, the force at which the blood pumps through the body increases. This leads to high blood pressure.

Plaque formation and buildup cause atherosclerosis. This condition can increase the risk of heart attack, stroke, and peripheral arterial disease (PAD). PAD can include any number of diseases that impact the arteries that carry blood to distant parts of the body.

High Blood Pressure: Symptoms and Tests

Your heart pumps about 2,000 gallons of blood throughout your body each day. The force at which the blood is pumped through your arteries is called blood pressure.

High blood pressure rarely has symptoms. The only way to know if you have it is to have your blood pressure checked by your doctor.

Elevated blood pressure (hypertension) doesn't usually have symptoms. This is why it’s nicknamed the "silent killer."

According to the American Heart Association, nearly half of Americans over the age of 20 have high blood pressure. Half of those with high blood pressure do not know they have it.

Measuring Blood Pressure

Blood pressure is measured in millimeters of mercury (mm Hg). The measurement includes two different numbers:

  • Systolic blood pressure (the top number) is the force at which blood is flowing during a heartbeat.
  • Diastolic blood pressure (the bottom number) is the force of blood when your heart is between beats.

Measuring blood pressure is a common, non-invasive medical test. A healthcare professional might use a digital blood pressure machine or a blood pressure cuff and a stethoscope to check your blood pressure.

The following chart shows the values for normal, borderline, high, and extremely high blood pressure. Extremely high blood pressure is considered a hypertensive crisis, which requires immediate medical attention.

Blood Pressure Category Systolic   Diastolic
Normal below 120  and below 80
Elevated 120–129  and below 80
Stage 1 Hypertension 130–139  or 80–89
Stage 2 Hypertension 140 or higher  or 90 or higher
Hypertensive crisis above 180  and/or above 120
Source: American Heart Association

Complications of Diabetes and High Blood Pressure

When untreated or uncontrolled, both conditions can have serious health consequences. This can include cardiovascular disease, heart attack, stroke, peripheral arterial disease, and kidney disease.

Cardiovascular Disease

Cardiovascular disease is a general term for all diseases of the cardiovascular system. Complications of diabetes and high blood pressure can cause atherosclerosis, heart attack, stroke, and heart failure.

Peripheral Artery Disease

Peripheral artery disease (PAD) is the hardening of the arteries in the legs, arms, head, or abdomen. Decreased blood flow from the heart to other parts of the body can lead to pain and neuropathy.

Neuropathy is a condition that causes problems with the connections between the brain and the body. It can also lead to an increased risk of infection because of slow wound healing, death of tissue, and gangrene. People with diabetes and PAD are at increased risk of serious infections.

Kidney Disease

Kidney disease can occur when high blood sugar or blood pressure causes constriction and narrowing of the blood vessels in the kidneys. This makes the kidneys weaker. Blood vessel constriction also reduces blood flow to the kidneys and causes damage.

When damaged blood vessels are unable to do their job, they cannot filter and remove fluid and wastes. An excess buildup of fluid can cause blood pressure to get worse. This, in turn, causes more damage to the kidneys.

Treatment and Prevention 

Diabetes and high blood pressure can both be managed through lifestyle changes. For example, a person with these conditions may benefit from changing their diet, starting an exercise routine, quitting smoking, and losing weight. In some cases, medication may be prescribed.

One of the first steps to addressing high blood pressure is simply knowing you have it. You should also know what range would be the healthiest for you. When you know these numbers, you can work with your doctor on how to meet your blood pressure goal.

You also need to know your numbers if you have type 2 diabetes. You should know your blood sugar levels and what range you should aim for.

Diet

Eating to manage diabetes and high blood pressure is not a one-size-fits-all approach. In general, though, meal plans that focus on the quality and quantity of carbohydrates can help you manage your blood sugar levels.

Carbohydrates affect blood sugar levels. When carbs are metabolized, they turn into glucose. Fiber-rich carbohydrates like whole grains, non-starchy vegetables, and legumes can help reduce blood glucose changes. They can also provide vitamins, minerals, and antioxidants and increase feelings of fullness.

Following a plant-based diet, a Mediterranean style of eating, or a modified carbohydrate diet can help you manage diabetes and reduce blood sugar.

If you have high blood pressure, limiting your sodium intake can also help you keep your blood pressure in check. This is especially true if you are salt sensitive.

People with high blood pressure might benefit from the Dietary Approaches to Stop Hypertension (DASH) diet The DASH eating plan limits saturated and trans fat, sugar, and sodium and features plenty of:

  • Fruits
  • Vegetables
  • Whole grains
  • Fresh and dried herbs
  • Unsalted nuts and seeds
  • Legumes
  • Lean protein

No matter what eating plan you're following, a good rule is to eat two to three cups of non-starchy vegetables daily or to make half your plate non-starchy vegetables at each meal.

Exercise

Exercise helps manage blood glucose levels and high blood pressure by:

  • Strengthening your heart
  • Helping you reach and maintain a healthy weight
  • Utilizing glucose by increasing insulin sensitivity

When your muscles contract, your cells can use glucose for energy. Studies have shown that regular exercise can reduce your hemoglobin A1C (a three-month average of blood sugar levels).

If you take medication to lower your blood sugar or blood pressure, talk to your doctor before starting an exercise program. This is especially important if you take insulin or oral glucose medication that can cause hypoglycemia.

Quit Smoking

If you smoke and have diabetes, high blood pressure, or both, get the help you need to quit. Quitting can significantly improve your health and make it easier to manage your conditions.

Smoking makes it harder to control diabetes because it:

  • Increases inflammation
  • Raises your bad cholesterol
  • Raises your blood pressure
  • Reduces the amount of oxygen supplied to your organs

Over time, quitting can also lower the risk of further blood vessel damage.

Weight Management

Modest weight loss has been shown to significantly improve blood sugar levels. Losing weight has many benefits for people with diabetes, including:

  • Improves insulin sensitivity
  • Reduces inflammation
  • Improves vascular health

Weight loss can also help lower blood pressure by reducing the stress placed on the heart.

Studies have shown that losing about 10% of your body weight can improve blood sugar and reduce the need for medication. In some cases, weight loss can even put diabetes into remission.

Medication

For some people, medications can be used to help manage diabetes and high blood pressure.

People with type 1 diabetes need to take insulin daily. Those with type 2 diabetes may need to take oral diabetes medications and/or non-insulin injectables. They may also take insulin.

There are several classes of medications that help people with hypertension to control their blood pressure. These include:

Your doctor will prescribe medication based on how high your blood pressure is. Your other health conditions will also be taken into consideration.

Other medications may also be recommended by your doctor. For example, Kerendia (finerenone) is used for people with type 2 diabetes and chronic kidney disease to lower the risk of certain kidney and heart complications.

Sometimes, lifestyle changes like diet and exercise can help you reduce your medication use. Never stop taking medication or decrease your dose, however, without asking your healthcare provider.

Summary

People with diabetes often also have high blood pressure. Both conditions can cause damage to blood vessels and put a strain on the heart.

You can help control your blood sugar and high blood pressure by making lifestyle changes such as changing your diet and quitting smoking. Starting an exercise routine can also help. In some cases, medication may be needed.

If you have diabetes and are concerned about developing high blood pressure, many of these lifestyle changes can lower your risk. Make sure to see your healthcare provider regularly and keep your stress level in check. 

A Word From Verywell

While diabetes and hypertension do often go hand-in-hand, having one condition does not mean that you will get the other. You can take steps to manage both conditions and the complications they can cause. In some cases, the small changes you make can even prevent or reverse the conditions.

Talk with your healthcare provider and meet with a registered dietitian or certified diabetes care and education specialist. This can be a great way to get the support you need to meet your blood sugar and/or blood pressure goals.

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20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Johns Hopkins Medicine. Diabetes and high blood pressure.

  2. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes, heart disease, and stroke.

  3. American Diabetes Association. Diabetes and high blood pressure.

  4. American Diabetes Association. Get smart about risks and diabetes prevention.

  5. Cheung BM, Li C. Diabetes and hypertension: is there a common metabolic pathwayCurr Atheroscler Rep. 2012;14(2):160-166. doi:10.1007/s11883-012-0227-2

  6. National Heart, Lung, and Blood Institute. Atherosclerosis.

  7. American Heart Association. Heart facts infographic.

  8. Food and Drug Administration. High blood pressure—understanding the silent killer.

  9. American Heart Association. What is high blood pressure?

  10. American Heart Association. Understanding blood pressure readings.

  11. American Heart Association. Causes of heart failure.

  12. National Heart, Lung, and Blood Institute. Peripheral arterial disease.

  13. McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetesJ Geriatr Cardiol. 2017;14(5):342-354. doi:10.11909/j.issn.1671-5411.2017.05.009

  14. American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: Standards of medical care in diabetes—2022Diabetes Care. 2022;45(Supplement_1):S144-S174. doi:10.2337/dc22-S010

  15. American Heart Association. Managing blood pressure with a heart-healthy diet.

  16. American Diabetes Association. Blood sugar and exercise.

  17. American Diabetes Association. Win the fight to quit smoking.

  18. American Heart Association. Managing weight to control high blood pressure.

  19. Grams J, Garvey WT. Weight loss and the prevention and treatment of type 2 diabetes using lifestyle therapy, pharmacotherapy, and bariatric surgery: mechanisms of actionCurr Obes Rep. 2015;4(2):287-302. doi:10.1007/s13679-015-0155-x

  20. Food and Drug Administration. FDA approves drug to reduce risk of serious kidney and heart complications in adults with chronic kidney disease associated with type 2 diabetes.