Howstuffworks "Diabetes and Blood Pressure Medications"

If you have mild hypertension, you may be able to push your blood pressure back into the healthy range with lifestyle changes, namely exercise and a better diet. Chances are, however, that you'll need to take a drug -- or more than one at some point -- to get your blood pressure under control. A large study of patients with diabetes in the United Kingdom found that about one-third required three or more medications to keep their blood pressure at a safe level.

That may sound like a lot of pill popping, but consider the benefits: The same study found that patients who maintained tight control over their blood pressure reduced their risk of stroke (by 44 percent) and heart failure (by 56 percent). All diabetes-related deaths were reduced by 32 percent. The patients were also less likely to lose their eyesight, a common complication of hypertension and diabetes.

Diabetics may need medication to control their high blood pressure.

Furthermore, a 2004 Canadian study offers strong evidence that one class of drugs used to lower blood pressure -- a ngiotensin converting enzyme (ACE) inhibitors -- may offer diabetes patients a bonus. Researchers compared a large group of diabetes patients who took ACE inhibitors with a similar group of patients who did not use the drugs. None of the study participants had heart disease at the outset. After five years, researchers found that patients who took ACE inhibitors were 23 percent less likely to have died of heart disease. However, they were half as likely to have died of any cause, so ACE inhibitors appear to confer other healthful benefits in addition to protecting the heart and blood vessels.

This article covers ACE inhitibors, plus a variety of other medications, used to lower blood pressure. The first type, diuretics, is discussed next.

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read B lood Pressure Medications.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Diabetes and Diuretics

The usual description of diuretics, sometimes nicknamed "water pills," goes something like this: "These drugs act on the kidneys to draw fluid and salts from the body." That's a polite way of saying that diuretics make you urinate. A lot. To produce urine, the kidneys pull water out of the blood, which lowers the blood's volume and eases pressure in vessels. In small amounts, though, diuretics do not cause a perceptible increase in urination. But they do cause a perceptible decrease in blood pressure. So don't avoid taking a diuretic. They're an invaluable treatment for high blood pressure.

There are several varieties of diuretic drugs. One type, called thiazide, may increase blood sugar when taken in larger doses, so users who have diabetes must monitor their glucose. Other major side effects can include loss of potassium, which can be offset by taking supplements containing the mineral.

Another medication for high blood pressure is beta-blockers. Learn how beta-blockers work, and common side effects, in the next section.

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read Blood Pressure Medications.

Diabetes and Beta-Blockers

Beta-blockers interfere with nerve signals that cause the heart to beat fast and hard. (In fact, performers with stage fright sometimes take beta-blockers to help them deal with anxiety.) Beta-blockers also cause blood vessels to dilate, or widen, which further lowers pressure.

Beta-blockers (sometimes called beta-adrenergic blockers) cover up some symptoms of hypoglycemia, such as a racing heartbeat, which would allow a period of low blood sugar to go unnoticed. Other possible side effects include insomnia, fatigue, cold extremities, and erectile dysfunction. Infants born to women who used beta-blockers during pregnancy frequently have medical problems, including low blood sugar.

ACE inhibitors affect both blood pressure and insulin levels. Continue to the next section for more details on this type of medication.

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Read Hypoglycemia to learn about this condition and how to avoid it.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read Blood Pressure Medications.

Diabetes and ACE Inhibitors

This class of medications has a neat trick up its sleeve. ACE inhibitors prevent a harmless protein called angiotensin I from turning into its evil twin, a hormone called angiotensin II, which causes blood vessels to constrict. ACE inhibitors lower hypertension by keeping vessels relaxed, allowing blood to flow easily. ACE inhibitors may offer a twofer for diabetes patients, since they appear to reduce insulin resistance. Some studies show that these drugs (along with angiotensin antagonists) prevent the onset of diabetes.

One common side effect of ACE inhibitors is a dry cough. Users may also develop a skin rash, loss of taste, and, in rare instances, kidney damage.

Next we'll discuss a medication similar to ACE inhibitors: ARBs (angiotensin receptor blockers).

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read Blood Pressure Medications.

Diabetes and ARBs

Angiotensin receptor blockers (ARBs) are similar to ACE inhibitors, with a different modus operandi. Instead of preventing angiotensin II from forming, these drugs (also known as angiotensin antagonists) simply get in the hormone's way as it tries to constrict blood vessels. (If you want to get technical about things, they block angiotensin receptor sites in the blood vessels.)

Unlike ACE inhibitors, ARBs are less likely to cause coughing, so doctors often prescribe the pills to patients who can't hack the hacking. However, ARBs are more expensive than ACE inhibitors and may cause dizziness.

Continue to the next section to find out how calcium channel blockers can treat high blood pressure.

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read Blood Pressure Medications.

Diabetes and Calcium Channel Blockers

You already know that contractions of the cardiac muscles make your heart beat so that it can pump blood into vessels. But your blood vessels aren't just stiff tubes. The inner walls of blood vessels contain tiny muscles that allow the tube to contract and expand. Muscles need calcium to contract, so drugs that block the mineral from entering muscle cells help blood vessels to dilate. Calcium channel blockers are also prescribed for angina.

Some possible side effects from calcium channel blockers include palpitations, swollen ankles, and constipation.

Another "blocker" medication is alpha-blockers. Like beta-blockers, alpha-blockers interfere with nerve signals. But there are differences between beta-blockers and alpha-blockers. Learn what these are by reading the next page.

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read Blood Pressure Medications.

Diabetes and Alpha-Blockers

Like beta blockers, alpha-blockers interfere with nerve signals. But instead of acting on the heart, alpha-blockers prevent nerve impulses from triggering muscle contractions in blood vessels, allowing blood to flow easily. Doctors even prescribe the drugs to treat urinary problems caused by an enlarged prostate.

Some doctors avoid using alpha-blockers unless patients have failed on other drugs, since a large study found that they can cause heart failure and other cardiovascular problems. They may also cause dizziness or a sudden loss of blood pressure when you stand up.

The next section describes a type of blood pressure medication that acts directly on the brain.

Alpha-Beta-BlockersAlpha-beta-blockers are just what they sound like: A combination of alpha- and beta-blocking action, which slows the heartbeat and relaxes blood vessels, resulting in a drop in blood pressure.

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read Blood Pressure Medications.

Diabetes and Sympathetic Nerve Inhibitors

Talk about nipping a problem in the bud. Nerve inhibitors, sometimes called central agonists, act directly on the brain, snuffing out nerve signals that cause the heart to beat fast and blood vessels to constrict. These drugs, such as clonidine, alpha-methyldopa, and guanabenz, can cause dry mouth and fatigue; the latter probably explains why they are being studied as potential sleep aids.

Fortunately, there are a wide variety of medications that can succesfully treat high blood pressure in patients with diabetes. The information in this article can help you understand what your physician has -- or will -- prescribe for your particular situation.

VasodilatorsSeveral older medications, including hydralazine and minoxidil, dilate blood vessels. But because they appear to worsen heart conditions in some cases, they aren't prescribed often these days. However, here's a bit of hair-raising trivia: Doctors noticed that some of their bald male patients who took minoxidil grew back a bit of hair. Today the drug is sold in liquid form under the name Rogaine as a hair-growth tonic.

For more information on diabetes, and its effect on blood pressure and heart ailments, try the following links:

Diabetes and Heart Disease explains the relationship between these two conditions.
Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
For more information on medications that treat hypertension, read Blood Pressure Medications.

ABOUT THE AUTHORS:

Timothy Gower is a freelance writer and the author of several books. His work has appeared in many magazines and newspapers, including Prevention, Health, Reader's Digest, Better Homes and Gardens, Men's Health, Esquire, Fortune, The New York Times, and The Los Angeles Times.

ABOUT THE CONSULTANTS:

Dana Armstrong, R.D., C.D.E., received her degree in nutrition and dietetics from the University of California, Davis, and completed her dietetic internship at the University of Nebraska Medical Center in Omaha. She has developed educational programs that have benefited more than 5,000 patients with diabetes. She specializes in and speaks nationally on approaches to disease treatment, specifically diabetes.

Allen Bennett King, M.D., F.A.C.P., F.A.C.E., C.D.E. is the author of more than 50 papers in medical science and speaks nationally on new advances in diabetes. He is an associate clinical professor at the University of California Natividad Medical Center and cofounder and medical director of the Diabetes Care Center in Salinas, California.