High blood pressure (hypertension) is a sign that the heart and blood vessels are being overworked. The condition is a major factor in the health complications that occur in people with diabetes, and controlling blood pressure is crucial to maintaining good health.

High blood pressure occurs when the force of blood against artery walls becomes excessive. In people with diabetes, high blood pressure increases the risk of serious and life-threatening diseases, including:

• Vascular damage (diabetic angiopathy and atherosclerosis)
  
  
• Heart attack, other heart conditions and stroke
  
  
• Diabetic nephropathy and chronic kidney failure
  
  
• Eye diseases such as diabetic retinopathy and glaucoma

Most people with diabetes have or will develop high blood pressure. Because diabetes and high blood pressure are so closely linked, the American College of Physicians emphasizes that controlling blood pressure should be as high a priority for people with diabetes as controlling glucose (blood sugar).

In addition, people with diabetes are classified as hypertensive earlier than nondiabetics. Nondiabetics are considered to be hypertensive when their blood pressure measures 140/90 millimeters of mercury (mmHg) or higher. Blood pressure is considered high when either the top number (systolic pressure) or the bottom number (diastolic pressure) is above those levels. People with diabetes are classified as hypertensive when systolic pressure is 130 mmHg or higher, or diastolic pressure is 80 mmHg or higher.

The American Diabetes Association (ADA) and the National Heart, Lung and Blood Institute recommend that patients with diabetes and/or kidney disease receive treatment if their blood pressure is above 130/80 mmHg. These levels are slightly stricter than those recommended for the general population.

The ADA recommends that people with diabetes have their blood pressure checked during every visit to a physician, or at least two to four times each year.

Most cases of high blood pressure have no cure, but the overwhelming majority can be managed with diet and medication. In general, for every 10 mmHg reduction in systolic blood pressure, the risk for any diabetic complication is reduced by 12 percent, according to the U.S. Centers for Disease Control and Prevention.

Although diabetes is strongly associated with high blood pressure, diabetic individuals can also experience potentially dangerous low blood pressure (hypotension). Several factors linked to this condition can be addressed to reduce the risk of dizziness and fainting.