Lowered blood pressure—with a side of diabetes
It doesn't make any sense to cause one disease while working to cure or curb another. But when it comes to treatment options, a lot of you tell me you have no choice! I say, hang in there and exhaust all avenues.
For example, let's look at high blood pressure.
If you need to lower your blood pressure but are also at risk of developing diabetes, be wary of the type of blood-pressure medication you take.
Popularly prescribed diuretics and beta-blockers were recently found to be commonly associated with diabetes.
According to a report from The Lancet, the link was discovered through a look at clinical trials that involved over 143,000 people. In 22 different trials, these patients started with high blood pressure but were not diabetic.
Patients received treatment for their high blood pressure, with each participant using one of the classes of blood-pressure medication or a placebo. Diuretics and beta-blockers carried the highest association, the calcium-channel blockers were in the median range, and ACE inhibitors and ARBs (angiotensin-receptor blockers) had the lowest association with diabetes.
The commonly used diuretic called hydrochlorothiazide is the one you're most likely to encounter. Doctors like it because it's inexpensive and because there are a lot of studies and committees that recommend it. Unfortunately, since the knowledge regarding the increased risk of diabetes is relatively new, many doctors are sticking to their old prescribing habits.
There is a range of factors that your doctor should take into account when considering your risk for diabetes and whether or not to prescribe (or continue to prescribe) diuretics and beta-blockers. What's your family history of diabetes? How much do you weigh? Have you had any recent weight gain?
Those three should start the dialogue. It's important not only for your doctor to have you fill out a medical history form—but that he also actually uses it when considering what will work best for you.
If you have a pretty high risk for diabetes, the newer blood-pressure medications—ACE inhibitors and ARBs—may be what your doctor will prescribe. But there are obviously other factors to consider here as well, such as whether or not you've had a heart attack. If you have had a major heart attack, your doctor will probably go for the diuretic in order to prevent another one.
In my own practice, I've found in many cases that hypertension can be controlled by simple changes in diet, losing a little weight (even 10 pounds can make a difference), and exercising a little more. (A 30 to 45 minute brisk daily walk can work wonders.) This is a common-sense approach that should be tried first before starting a program involving any drug laden with side effects.
Also think about some of the risk factors for diabetes, which are the same. If you take care of the basics, you can not only benefit from lower blood pressure but also lower your risk of diabetes.
Ask your doctor to consider all options.
