When blood pressure is too high in people with diabetes

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In people with Type 1 diabetes, blood pressure usually rises only as a result of kidney damage. Whereas previously mainly normal blood pressure readings were obtained, as soon as microalbuminuria appears, the blood pressure begins to rise, although at first it may stay in the normal range. For example, if under normal albuminuria it was 125/80 mmHg, after the onset of microalbuminuria it might rise to 130/85 mmHg, then later to 135/90 mmHg. This is why there is no 'official' value for hypertension, but a rise in blood pressure compared with earlier values indicates increased stress for the heart, kidneys and blood vessels. Should macroalbuminuria then develop, or even renal failure, the blood pressure rises sharply if it is not treated promptly.

As well as people with Type 1 diabetes, every second or third person with Type 2 diabetes shows raised blood pressure as soon as metabolic disease begins. Because there is often no visible cause for the high blood pressure, people talk about 'essential hypertension'. In those with Type 2 diabetes, the blood pressure also begins to rise as soon as kidney function is impaired. In practice, all patients with renal damage have high blood pressure.

The lower the blood pressure, the less frequent is the occurrence of kidney or eye damage

Frequency or microangiopathy (%)

The lower the blood pressure, the less frequent is the occurrence of kidney or eye damage

Frequency or microangiopathy (%)

pressure (mmHg}

Figure 4.7 Damage to the small blood vessels (microangiopathy) is responsible for diabetic complications in the kidney and in the eye. When the blood pressure is low, the risk of such complications is greatly reduced. [8]

pressure (mmHg}

Figure 4.7 Damage to the small blood vessels (microangiopathy) is responsible for diabetic complications in the kidney and in the eye. When the blood pressure is low, the risk of such complications is greatly reduced. [8]

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