By Martha Funnell, MS, RN, CDE
Have you ever wondered how your doctor knows what to do, or why treatments change over time? Most healthcare providers today use “Standards of Care” to guide their decisions. In diabetes, the standards from the American Diabetes Association (ADA) are commonly used. Each year, the ADA reviews findings from all of the diabetes studies and revises its guidelines based on the results. The 2013 guidelines were recently published. One of the changes in this year’s guidelines is in the blood pressure target.
1 BLOOD PRESSURE FACTS
Blood pressure is the amount of pressure on your blood vessel walls when your heart is pumping (top number) and between beats (bottom number). Along with high blood glucose levels, high blood pressure increases your risk for strokes, heart attacks, kidney damage and eye disease. If you have been told you have high blood pressure (hypertension), it means the top (systolic) number is too high, the bottom (diastolic) number is too high or both are too high.
2 NEW TARGETS FOR BLOOD PRESSURE
The new target blood pressure guideline for people with diabetes is less than 140/80 mmHg. The previous target was less than 130/80 mmHg. This change was made because studies have shown that there is no benefit to lowering the blood pressure from 140/80 to 130/80 mmHg. The risk for a heart attack, stroke, kidney damage and death is about the same at less than 140/80 or 130/80 mmHg.
3 KEYS TO SUCCESS
Although this may seem like a change from the past target of 130/80 mmHg, it is only part of the picture. Normal blood pressure for everyone, including people with diabetes, is still 120/80 mmHg.
- If your blood pressure is between 120/80 and 140/80 mmHg, lifestyle changes, such as weight loss, physical activity or a DASH eating plan, are recommended.
- If your blood pressure is 140/80 mmHg or higher, your healthcare provider is likely to prescribe medicine to help you reach your target.
- If your blood pressure is less than 140/80 mmHg, if you have no other health problems and can reach the less than 130/80 mmHg target without any “undue burden” (such as cost or side effects from blood pressure medicines), your target may still be lower than 130/80 mmHg. Talk with your provider about your blood pressure and the best target for you.