There is still some confusion on the guidelines about high blood pressure, a condition that can lead to and worsen diabetes complications.
Though the U.S. and countries around the globe have agreed on most practices revolving around high blood pressure, or hypertension, one discord remains: whether to approve the loosened recommendation that hypertensive individuals age 60 or older who do not have diabetes or kidney disease should start drug treatment only if systolic pressure reaches 150 mm HG or higher or diastolic pressure reaches 90 mm Hg or higher.
At the end of last year, the recommendation was published by Journal of the American Medical Association despite no backing by the National Heart, Lung and Blood Institute or any other group.
The American Heart Association and American College of Cardiology have both said they will not endorse the JAMA guideline.
What's more, while some doctors defended the recommendation - saying there was insufficient evidence to support a lower threshold of 140/90 mm Hg - many more others voted against making the change.
As a result of the tug-of-war between medical professionals, there may be a "guide to the guidelines" document coming out soon.
"I think what you're going to see coming forward, probably within the next year, is how to distill out the essence of the guidelines and apply them at the bedside," Dr. Domenic Sica, president-elect of ASH and a hypertension specialist at Virginia Commonwealth University in Richmond, told MedPageToday. "The consensus document [in JAMA] never was able to distill out the essence and give you how do you apply it at the bedside."
Link between high blood pressure and diabetes
What experts do agree on is this: Having type 1 or type 2 diabetes increases the risk of high blood pressure and other heart problems because diabetes damages arteries and makes them targets for hardening. At the same time, hypertension exacerbates diabetes complications, including kidney disease and diabetic eye disease.
With all the mixed signals, it's important for diabetic patients to learn about confirmed information. A possible solution is diabetes education. Giving diabetics a better grasp on their disease may help reduce blood sugar, blood pressure and cholesterol levels, according to new data from the Diabetes Self-Management Education Program.
In the study, 1,263 people living with diabetes received one-on-one sessions with diabetes educators. After a year of the sessions, participants on average lowered their A1C (blood sugar) levels by 67 percent and their LDL (bad) cholesterol levels by 53 percent. Before the study, about 32 percent of patients had high blood pressure, compared to 25 percent after the study. All in all, understanding diabetes is the first step to managing the disease.
"Diabetes education is not only helpful, it's necessary for people with the condition. It's designed to empower patients to self-manage and reach their goals," said Lovelyamma Varghese, MS, FNP, BC, RN, and Director of Nursing Practice and quality for the Ambulatory Care Network at New York-Presbyterian Hospital, New York.
Talk with your doctor about the most appropriate blood-pressure goal for you.
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