Hypertension and diabetes management 18 April 2023 Hypertension (high blood pressure) and diabetes are two of the most prevalent chronic diseases worldwide. These conditions are significant health risks and can lead to serious complications if left unmanaged. This article explores the relationship between high blood pressure and diabetes, their causes, and the best ways to help people manage these conditions. Understanding hypertension Hypertension, high blood pressure, is a condition in which the force of blood against the artery walls is constantly high. This can lead to damage to the blood vessels, and anywhere the blood vessels lead to, including the heart and other organs over time. Hypertension is a leading cause of heart disease, stroke, and kidney disease. World Hypertension Day is on May 17th this year. This day was first initiated by the World Hypertension League in 2005 to raise awareness about hypertension, its impact on health, and how to prevent and treat. According to the World Health Organization (WHO), hypertension is one of the most significant causes of premature death worldwide, affecting 1.28 billion adults globally. Despite being a preventable and treatable condition, many people are still unaware of the risks of hypertension and the importance of managing blood pressure well. The theme for World Hypertension Day 2023 is “Measure Your Blood Pressure, Control It, Live Longer.” This theme emphasises the importance of regularly monitoring blood pressure levels and taking steps to manage levels to reduce the risk of developing serious health problems. Hypertension and diabetes Hypertension and diabetes are closely related. Many people living with diabetes also develop hypertension. The exact reason for this link is not fully understood, but it is thought that constantly high blood glucose levels damages blood vessels, leading to higher blood pressure. Additionally, hypertension can make insulin in the body work less efficiently, leading to higher blood glucose levels in people living with diabetes. This can create a damaging cycle of blood glucose levels above target ranges and high blood pressure, which can lead to serious blood vessel and organ problems. According to the Australian Institute of Health and Welfare, 31% of Aboriginal and Torres Strait Islander adults have high blood pressure. High blood pressure was one of the leading risk factors contributing to the gap in attributable disease burden in 2018, accounting for 6.5% of the health gap between Indigenous and non-Indigenous Australians. Along with lifestyle and behavioural influences, stress, common for many Aboriginal and Torres Strait Islander people due to historical trauma and ongoing trauma and discrimination, can increase the risk of hypertension, and other chronic conditions such as diabetes. Managing hypertension and diabetes Managing hypertension and diabetes requires a combination of health-promoting behaviour changes and often medication. Here are some ways to help support people living with diabetes to manage their blood pressure: Encourage people to seek support for their social and emotional wellbeing, for help with managing stress: Encourage people to reach out to their trusted health care or social support team who can often help with social and emotional support directly or support them to talk with their General Practitioner (GP). GPs can explore possible support systems including a mental health plan to see a psychologist on an on-going basis. Also remind people if they are feeling worried or not good, to reach out online to MindSpot or over the phone to Yarning Safe and Strong, 13YARN (13 92 76) or 000 if they feel their life is in danger Encourage people to take their blood pressure medication if and as prescribed: For a person living with hypertension and/or diabetes, it is important for them to know which medication does what, and how to take their medication as prescribed by their GP. This can help control both blood pressure and blood glucose levels. A Pharmacist is well placed to talk about medications, side-effects, and annual medication reviews to ensure the correct tablets are being prescribed and taken, and to also work with clients regarding side-effects and other concerns when it comes to taking medications Encourage regular movement and or exercise: Regular exercise can help manage both hypertension and diabetes and has great benefits for social and emotional wellbeing. Encourage people to move and or exercise, or to speak with an exercise physiologist if available for support. At least 30 minutes of moderate intensity exercise most days of the week is generally recommended Encourage regular blood pressure and blood glucose levels monitoring: Regular monitoring of blood pressure and blood glucose levels can help people see patterns in their levels, including how stress, movement or medications can affect their levels. Meaningful monitoring of blood pressure and glucose levels can greatly help some people manage their hypertension and diabetes better and thereby help to reduce their risk of complications Encourage healthier eating and meal patterns, and relationships with food: Eating nutrient dense foods such as fresh or frozen fruits and vegetables, whole grains, lean meat and/or meat alternatives, low fat dairy (milk and yoghurt) and a moderate amount of healthy fats (olive oil, avocado, nuts and seeds) helps to support our physical and mental health. However for many, access to affordable nutrient-dense food choices isn’t always possible. Highly processed food can be high in refined sugar, salt and less healthy types of fats which can make it harder to keep blood pressure and glucose levels in safe target ranges Encourage people to eat less salt: Most of the salt in our diets come from highly processed foods, such as takeaway foods, biscuits, crisps, bakery products etc. Salt can contribute to increasing blood pressure. Encourage people to cook with less salt and use minimal on their foods and meals Body weight: Our behaviours including how much we move, how much nutrient-dense food and water we eat and drink, how much we smoke, vape or drink alcohol, take or not take our medications, how our body and mind deals with various hormonal changes, how we can or can’t stay on top of our social and emotional wellbeing and stresses and or how well we sleep, may or may not affect our body shape. However regardless of our natural or diet-induced body weight set-point, health-promoting behaviours such effective stress management, moving more, taking prescribed medications if necessary, attending health appointments, where possible enjoying more nutrient-dense foods and drinking more fresh clean water, can all help to lower and or manage blood pressure and glucose levels, and therefore help to prevent hypertension and diabetes complications regardless of weight loss Encouraging people living with diabetes to meet with their health care team regularly to check blood pressure levels and or to monitor at home, can have great benefits for reducing blood pressure and therefore preventing the consequences of hypertension – heart attack, stroke, and kidney disease. For more information on diabetes education for the health workforce and or people living with or at risk of diabetes, please click here or call the NDSS Helpline on 1800 637 700 to speak with a health professional.