October 10, 2014 – Keeping Control

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Anchor lead: Just how low do you need to go if you have diabetes and high blood pressure? Elizabeth Tracey reports

People with diabetes who also keep blood pressure down reduce their risk of mortality, a recent study confirmed.  Yet other studies have shown that since blood pressure rises as we age, slightly higher levels are still acceptable.  What’s the best strategy?  Gregory Prokopowicz, a blood pressure expert at Johns Hopkins, reviews the data.

Prokopowicz: The guidelines have changed with respect to patients with type 2 diabetes. We don’t need to be quite as aggressive in that population we can accept a goal of 140/90. And I think that’s worth bearing in mind because a lot of people who have diabetes and high blood pressure are on a lot of meds.  To get their blood pressure down to 130/80 you may be having them on three, four, five antihypertensive medications in addition to perhaps two or three diabetes medications plus probably something for cholesterol.  Now you’ve got eight, ten, twelve medications.  It’s very difficult to manage all that.    :32

Prokopowicz says seeking a consult with someone with an interest in this field may allow the numbers of medicines to be reduced.  At Johns Hopkins, I’m Elizabeth Tracey.