Ask An Expert: Diabetes and Blood Pressure

Content provided by the Faculty of the Harvard Medical School

Ask An Expert: Diabetes and Blood Pressure

Question:

Is it absolutely necessary for a diabetic who does not have high blood pressure to take a blood pressure pill anyway?

Answer:

If you have diabetes, your risk for heart attack and stroke will be lowered substantially if you keep your blood pressure at ideal numbers. For a person with diabetes, the goal for blood pressure is lower than it is for most people. You should keep your blood pressure's top number (systolic pressure) less than 130 millimeters of mercury (mmHg), and your blood pressure's bottom number (diastolic number) less than 80 mmHg.

If your blood pressure is normal, this is probably not what your doctor is concerned about. There may be a different reason that your "blood pressure" pill was recommended. In people with diabetes, two common groups of blood pressure medicines are used to protect the kidneys, slowing the damage that diabetes can cause. These drugs are known as "ACE inhibitors" and "angiotensin receptor blockers." A medicine from one of these groups is recommended for people with diabetes who have protein in the urine, even if they don't have high blood pressure. A small amount of protein in the urine (called "microalbumin") is an early sign of kidney injury from diabetes.

ACE inhibitors include lisinopril (Zestril or Prinivil), enalapril (Vasotec), moexipril (Univasc), fosinopril (Monopril) and several other medicines. Angiotensin receptor blockers include losartan (Cozaar), candesartan (Atacand), valsartan (Diovan) and several others.

Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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