High blood pressure (also called hypertension) is common in people who have diabetes, particularly if they are overweight. In fact, up to 80 per cent of people with type 2 diabetes will develop high blood pressure at some stage. For type 1 diabetes, the figure is in the region of 30 per cent.
Unfortunately, diabetes makes high blood pressure more difficult to treat, and high blood pressure adds to the dangers of diabetes. So it is not surprising that your doctor will want to get your blood pressure down and, if you have diabetes, your target blood pressure levels are likely to be lower than if you don’t.
You may well be given advice to lose weight, take more exercise, cut down on salt and eat a healthy diet with plenty of fruit and vegetables. While these are valid guidelines, the advice given is often not sufficiently detailed and specific to result in a reduction in blood pressure in the short term and your doctor will probably also prescribe medication. One of the first ‘drugs of choice’ is likely to be an angiotensin converting enzyme inhibitor (ACE Inhibitors) , or ACE inhibitor for short.
ACE inhibitors work by blocking the action of an enzyme that breaks down an artery-dilating peptide called bradykinin. So taking an ACE inhibitor means more bradykinin in the bloodstream, more relaxed arteries and lower blood pressure. So far, so good, but high bradykinin levels also cause the unpleasant or dangerous side effects that come with ACE inhibitors. Everybody who is prescribed these drugs needs to be aware of the following warning signs:
• Headaches, dizziness, fatigue and nausea;
• A relentless, dry cough that just won’t shift;
• Angioedema, a swelling of the face, tongue and throat that can occur with alarming speed and can cause suffocation by blocking the airway;
• Impaired kidney function, particularly if taken together with diuretics and NSAID-type painkillers.
Dr James R. Roberts, director of emergency medicine at Mercy Philadelphia Hospital in the USA, sees about one case a week of ACE inhibitor-related angioedema, many of which prove to be fatal. He has described the condition as a ‘silent epidemic’ that is not appreciated by the public or by many doctors. And the combination of ACE inhibitors, diuretics and NSAIDs has been described as a ‘triple whammy’ that significantly increases the risk of acute kidney damage.
Two other things to bear in mind: ACE inhibitors can cause birth defects and should never be taken by women who are likely to become pregnant; and don’t take potassium supplements alongside these drugs, since they block potassium excretion from the body and if your potassium level gets too high it can cause dangerous heartbeat irregularities. You can find more information about ACE inhibitor drugs here:
How to reduce your blood pressure safely without taking drugs
Fortunately, there are plenty of safe and effective ways to bring down your blood pressure and reduce your reliance on ACE inhibitors and other dangerous drugs. Here are my top tips:
• Vitamin D – a new study has shown that low levels of this essential substance are a direct cause of elevated blood pressure. Take a supplement of at least 2000 IU a day.
• CoQ10 – taking 100 to 120 mg a day can reduce blood pressure by up to 17 mmHg systolic and 10 mmHg diastolic. Make sure you take the most bioavailable form of CoQ10, known as Ubiquinol.
• Garlic – has been found to reduce blood pressure in several studies. Include it in your diet regularly or take a supplement of aged garlic extract.
• Fish Oil – the blood pressure lowering effect of fish oil has recently been confirmed in a systematic study of 17 clinical trials.
• Eat your greens – the potassium, magnesium and vitamin C they contain can help to bring down your blood pressure.
• Cut out sugar and follow a low-carb diet, as described in Diabetes Defeated: The 14 Day Diet Plan.
• Exercise more – there are plenty of studies to show that exercise reduces blood pressure. Aerobics, resistance training and endurance exercise all seem to work, so take your pick!
Bringing down your blood pressure is just one of the many benefits that can be obtained from fish oil. Now, a new study has shown that EPA (eicosapentaenoic acid), one of the fatty acids present in fish oil, improves insulin sensitivity in overweight people with type 2 diabetes. I’ll be giving you the full story on this in my next blog post.
Wishing you the best of health,
PhD DHD Nutritionist
for Real Diabetes Truth
Bear in mind we are not addressing anyone’s personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.
1. Roberts JR, Lee JJ, Marthers DA. Angiotensin-converting enzyme (ACE) inhibitor angioedema: the silent epidemic. Am J Cardiol. 2012; 109(5):774-775.
2. Lapi F, Azoulay L, Yin H, Nessim SJ, Suissa S. Concurrent use of diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers with non-steroidal anti-inflammatory drugs and risk of acute kidney injury: nested case-control study. BMJ. 2013; 346:e8525.
3. Vimaleswaran KS, Berry DJ, Cavadino A et al. A causal association between vitamin D status and blood pressure: a Mendelian randomization study in up to 150,846 individuals. European Human Genetics Conference, 8-11 June 2013, Paris, France.
4. Rosenfeldt FL, Haas SJ, Krum H, Hadj A, Ng K, Leong JY et al. CoenzymeQ10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens. 2007; 21:297–306.
5. Campbell F, Dickinson HO, Critchley JA, Ford GA, Bradburn M. A systematic review of fish-oil supplements for the prevention and treatment of hypertension. Eur J Prev Cardiol. 2013; 20(1):107-120.
Category: Diabetes Risks