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The Link Between Diabetes and Hypertension

Nina Ghamrawi, MS, RD, CDE
October 24, 2023
August 29, 2024
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High blood pressure, or hypertension, is a condition that’s seen in people with type 2 diabetes. It’s believed that the following contribute to both conditions, however:

  • obesity
  • a diet high in fat and sodium
  • chronic inflammation
  • inactivity

If you have any of the above, your risks of both diabetes and hypertension may be higher.

According to the American Diabetes Association (ADA), the combination of high blood pressure and type 2 diabetes is particularly lethal and can significantly raise your risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease and retinopathy. Diabetic retinopathy may cause blindness.

There’s also significant evidence to show that chronic high blood pressure can speed the arrival of problems with the ability to think that are associated with aging, such as Alzheimer’s disease and dementia. According to the AHA, blood vessels in the brain are particularly susceptible to damage due to high blood pressure. This makes it a major risk factor for stroke and dementia. Uncontrolled diabetes isn’t the only health factor that increases risk for high blood pressure.

Your chances of having a heart attack or stroke increase exponentially if you have more than one of the following risk factors:

  • family history of heart disease
  • high-fat, high-sodium diet
  • sedentary lifestyle
  • high cholesterol
  • advanced age
  • obesity
  • current smoking habit
  • too much alcohol
  • chronic diseases such as kidney disease, diabetes, or sleep apnea

Pathophysiology

If you're looking for more answers, here's a more scientific explanation on why diabetes and hypertension are linked.  People with diabetes experience typically one of two phenomenon that increase risk for hypertension:

  • Increased peripheral artery resistance, or less elasticity of blood vessels: caused by structural changes in blood vessels that happens when we have long-term physical changes in blood flow- like from months or years of lack of exercise or poor diet.
  • Increased body fluid volume associated with insulin resistance: caused by years of high blood glucose and high blood insulin levels. Both of these mechanisms (increased arterial resistance and higher blood fluid volume) elevate systemic blood pressure.

Takeaways

Based on current research, high blood pressure doesn't lead to increased risk for Diabetes, but having Diabetes can significantly increase risk for high blood pressure. So if you have diabetes right now and you don't have hypertension, do your best to keep glucose under control, and your blood pressure will likely stay more stable as a result.

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