Wednesday, September 13, 2017

Controlling Your Blood Pressure

Keeping your blood pressure in check is particularly important in preventing
the macrovascular complications of diabetes. But elevated blood pressure
also plays a role in bringing on eye disease, kidney disease, and neuropathy.
You should have your blood pressure tested every time you see your doctor.
The goal is to keep your blood pressure under 130/80. (See Dr. Rubin’s book
High Blood Pressure For Dummies, 2nd edition, published by Wiley, for a complete
explanation of the meaning of these numbers.) You may want to get
your own blood pressure monitor so that you can check it at home yourself.
The statistics about diabetes and high blood pressure are daunting. Seventyone
percent of diabetics have high blood pressure, but almost a third are
unaware of it. Almost half of them weren’t being treated for high blood pressure.
Among the treated patients, less than half were treated in a way that
reduced their pressure to lower than 130/80.
You can do plenty of things to lower your blood pressure, including losing
weight, avoiding salt, eating more fruits and vegetables, and, of course, exercising.
But if all else fails, your doctor may prescribe medication. Many blood
pressure medicines are available, and one or two will be exactly right for you.
See High Blood Pressure For Dummies, 2nd Edition, for an extensive discussion
of the large number of blood pressure medications.
One class of drugs in particular is very useful for people with diabetes with high
blood pressure: angiotensin converting enzyme inhibitors (ACE inhibitors),
which are especially protective of your kidneys. If kidney damage is detected
early, ACE inhibitors can reverse the damage. Some experts believe that all
diabetics should take ACE inhibitors. We believe that if there’s no evidence of
kidney damage and the diabetes is well controlled, this isn’t necessary.

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