Question: I have type 2 diabetes as well as high blood pressure. My diabetes seems to be under control and my blood pressure is much better due to meds and, this is no joke, retiring. It has dropped from 135/90 to 109/73. What is the interrelationship between type 2 diabetes and high blood pressure? Can high blood pressure help cause diabetes?
Dr. Hibberd's Answer:
Diabetes accelerates vascular disease, and co-existence of the two conditions is quite common. Diabetes does not "cause" hypertension. Many medications (ACE inhibitors and ARB's) commonly used to protect the kidneys of diabetics also tend to lower blood pressure, so the drop in your blood pressure readings has no reflection on your diabetic control.
Be sure your doctor is aware of this change. Any question of whether this is related to deterioration in your heart’s ability to contract or pump can easily be diagnosed by a simple, non-invasive study called a 2D echocardiogram. If there is reason for concern, other imaging scans such as a MUGA scan or a stress echocardiogram can be ordered.
Concern about arterial blood supply to the heart is usually answered by stress studies with an imaging agent, such as cardiolyte, or cardiac catheterization. The CTT scan of coronary arteries establishes a risk score for coronary artery disease based on the presence of coronary artery calcifications (none is good!). It is quite useful and has been popular in Britain and Europe for many years, and is beginning to be used in this country despite the objections to coverage by insurance companies.