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Understanding the Link Between Hypertension and Diabetes

Hypertension and Diabetes: Treatment Goals

Summary & Participants

It's long been known that diabetes often goes hand-in-hand with high blood pressure. But many of the 11 million Americans that have both conditions don't get the treatment they need. Join experts as they discuss why people with diabetes also need to focus on controlling their blood pressure.

Medically Reviewed On: July 01, 2008

Webcast Transcript

MABEL JONG: So basically, with certain lifestyle and diet modifications, it sounds like these are diseases that you can control, as opposed to something like cancer.

WILLIAM WHITE, MD: This is a good way to think of this: This is not a curable disorder, but a treatable disorder, and that is, in fact, a big difference. In many cases, though, it's a serious problem, because the end result of having uncontrolled diabetes and uncontrolled hypertension is just as bad as having uncontrollable or untreated cancer.

MABEL JONG: Do we know, Dr. Sica, what's more important, to control blood sugar or blood pressure?

DOMINIC SICA, MD: We probably should never separate those two, although some information suggests there is an attendant greater benefit in a diabetic to blood pressure reduction for certain complications, and for others a benefit from tight blood sugar control. One should never argue the point to try and prefer one versus the other.

MABEL JONG: Are all people who have both conditions being treated with blood pressure medicine?

DOMINIC SICA, MD: It is very uncommon for a hypertensive diabetic being treated for their high blood sugars not to be receiving blood pressure medication for their hypertension.

MABEL JONG: How many different types of medications are people with both hypertension and diabetes typically on?

WILLIAM WHITE, MD: Well, I would say on average that you would be on two or three blood pressure-lowering drugs and approximately two agents which lower the blood sugar, if you're not on insulin. So that's probably about five drugs per patient, if the condition is relatively controllable and relatively mild to moderate. In some of our more severe patients, you can almost double that.

MABEL JONG: And are there side effects, like being drowsy at certain times of the day?

WILLIAM WHITE, MD: Every class of anti-hypertensive drug has some of its own distinct little side effects. Fortunately, the medications have gotten so much better during the last 20 years that we actually see many of the new drugs having no more side effects than placebo pills or sugar pills.

DOMINIC SICA, MD: I would also maybe add that the problem of polypharmacy or multiple prescriptions is such now that most physicians' knowledge of how to give a drug and the wide range of drugs within a specific drug class allow things to be given in a way where side effects are really minimized.

MABEL JONG: Can you outline some success rates from using these drugs, Dr. Sica?

DOMINIC SICA, MD: The success is both immediate and then it's realized long term. The immediate gain is by blood pressure coming under control. The long-term gain will never really be identified in a specific patient, but will be identified in a population sense, so being exposed to these medicines means a lesser risk of developing coronary artery disease, congestive heart failure and likely a lesser progression onto various elements of chronic renal failure.

MABEL JONG: Closing comments, Dr. White?

WILLIAM WHITE, MD: We've learned an awful lot just in the last couple of years about the management of the hypertensive patient with diabetes. We've learned specific new information about certain classes of drugs, and therefore we are able to provide to patients a more refined drug treatment plan, even though it's a lot of drugs, that will actually reduce their morbidity, and that's a very positive thing, considering what we knew a few years ago.

MABEL JONG: A last word from you, Dr. Sica?

DOMINIC SICA, MD: I think the more information we can get to patients about these diseases, so we self-empower them to became active participants in their own health care plan, is the best way we're going to solve this problem. If you educate the patient, you very importantly create the basis for future success with the therapies that you apply.

MABEL JONG: Dr. Sica, Dr. White, thanks for joining us today. And thank you for watching our webcast. I'm Mabel Jong.

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