Managing Other Chronic Conditions

How are High Blood Pressure and Chronic Conditions Related?

High blood pressure often comes with other health issues. Many people with high blood pressure also have diabetes or high cholesterol. Making healthy choices to improve your blood pressure will likely help those other health problems too. For example, being more active and eating healthier can improve your blood pressure, blood glucose, and cholesterol levels.

What Is Diabetes Mellitus (Diabetes)?

Diabetes means your body cannot use or make enough insulin to keep your blood sugar at the right level. This causes high blood sugar levels. Things that raise your risk for diabetes include not being physically active, sedentary behavior, drinking too much alcohol, being overweight, smoking, uncontrolled high blood pressure, and high cholesterol. Symptoms include blurry vision, peeing a lot, feeling very thirsty, being tired, and losing weight without trying. About two out of three adults with diabetes also have high blood pressure. Health problems linked to diabetes are kidney disease, vision loss, heart disease, nerve damage, and stroke.

What are the Different Types of Diabetes?

• Prediabetes: May be a precursor to developing type 2 diabetes where blood sugar levels are higher than normal (between 100 mg/dl and 125 mg/dl). Increasing physical activity and losing weight can lower the risk of getting diabetes.
• Type 1 Diabetes: Insulin-dependent affects about 5-10% of diabetics. The body is unable to produce insulin because the immune system destroys the insulin producing cells.
• Type 2 Diabetes: The most common form of diabetes which affects 90-95% of diabetics. The body does not produce enough insulin because of insulin resistance.

What Does My HbA1C Results Mean?

This stage of diabetes is diagnosed using a blood test, HbA1C, which measures the amount of blood sugar (or glucose).

What Is High Cholesterol?

Cholesterol is a waxy, fat-like substance that our liver makes. We also get cholesterol from foods like eggs, meat, fish, dairy, and seafood. Cholesterol is important for our cells and helps make vitamin D and hormones. Too much cholesterol in our blood can be bad. High cholesterol means having more than 240 milligrams of cholesterol per deciliter (mg/dl) of blood. When there is too much, it can stick to the walls of our arteries. Our arteries are the blood vessels that carry blood to our heart and brain. When cholesterol builds up in our arteries, it is called plaque. Having high blood pressure and high cholesterol at the same time means a bigger risk of heart disease.

How is your cholesterol level measured?

• Total cholesterol: the total amount of blood cholesterol based on HDL, LDL, and triglycerides. Healthy levels (< 200 mg/dl).
• High density lipoprotein (HDL) – “good cholesterol”: takes extra cholesterol from different parts of the body to the liver. The liver gets rid of it from the body. Healthy levels (men: > 40 mg/dl; women: > 50 mg/dl).
• Low density lipoprotein (LDL) – “bad cholesterol”: high levels (100 mg/dl or greater) stick to the artery walls as plaque and increases the risk of stroke and heart disease.
• Triglycerides: the most common types of fat found in the body – mainly from the fat we consume. Triglycerides carry fats to our cells. High levels (150 mg/dl or greater) can raise your “bad cholesterol” and increase your risk of heart disease.

Why does High Cholesterol and Diabetes Matter for High Blood Pressure?

Three percent of adults have hypertension, diabetes, and high cholesterol all at the same time. Thirteen percent of adults have two of the three conditions. Black adults (4.6%) are more likely than White adults (2.5%) to have all three conditions at once.

References

Johns Hopkins Medicine. (2023). Diabetes and high blood pressure. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetes-and-high-blood-pressure

Brutsaert, EF. (2022). Diabetes Mellitus (DM). In Merck Manual Professional Version. Merck & Co., Inc. Retrieved July 20, 2023, from https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetes-mellitus-dm

Przezak, A., Bielka, W., & Pawlik, A. (2022). Hypertension and Type 2 Diabetes-The Novel Treatment Possibilities. International journal of molecular sciences, 23(12), 6500. https://doi.org/10.3390/ijms23126500

Tsao et al. Heart disease and stroke Statistics—2023 update: A report from the American Heart Association. Circulation.2023;147. https://doi.org/10.1161/CIR.0000000000001123

Punthakee, Z., Goldenberg, R., Katz, P. (2018). Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Canadian Journal of Diabetes 42 (Supplement 1) S10-S15 https://doi.org/10.1016/j.jcjd.2017.10.003

American Heart Association News. (2022, December 13). This type of cholesterol could be bad in people with high blood pressure. https://www.heart.org/en/news/2022/12/13/this-type-of-cholesterol-could-be-bad-in-people-with-high-blood-pressure

American Heart Association. (2022). What is cholesterol. What is Cholesterol? (heart.org)

Centers for Disease Control and Prevention [CDC]. (2023, March 20). About Cholesterol. https://www.cdc.gov/cholesterol/about.htm

National Heart, Lung, and Blood Institute. (2019, July 19). Wake-up call: high blood pressure and cholesterol in young adults associated with later heart disease. https://www.nhlbi.nih.gov/news/2019/wake-call-high-blood-pressure-and-cholesterol-young-adults-associated-later-heart-disease

Colantonio, L. D., Anstey, D. E., Carson, A. P., Ogedegbe, G., Abdalla, M., Sims, M., Shimbo, D., & Muntner, P. (2017). Metabolic syndrome and masked hypertension among African Americans: The Jackson Heart Study. Journal of clinical hypertension (Greenwich, Conn.), 19(6), 592–600. https://doi.org/10.1111/jch.12974

Escott-Stump, S. (2022). Nutrition and Diagnosis-Related Care. 9^th Edition. Academy of Nutrition and Dietetics. (pp. 743-746).

National Heart, Lung, and Blood Institute. Metabolic Syndrome. (2022, May 18). What is metabolic syndrome? https://www.nhlbi.nih.gov/health/metabolic-syndrome

(Escott-Stump, S. (2022). Nutrition and Diagnosis-Related Care. 9^th Edition. Academy of Nutrition and Dietetics. (pp. 743-746).

Subramanian, M., Wojtusciszyn, A., Favre, L., Boughorbel, S., Shan, J., Letaief, K. B., Pitteloud, N., & Chouchane, L. (2020). Precision medicine in the era of artificial intelligence: implications in chronic disease management. Journal of translational medicine, 18(1), 472. https://doi.org/10.1186/s12967-020-02658-5