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Question:

From Ohio, USA:

I am a 23 year-old, who has had type 1 diabetes for over five years, and I have a family history of hypertension on both sides. Recently, I have been checking blood pressure at the checking stations in drug stores and the like and have been getting readings in the "borderline" range (e.g., systolic between 130-140, diastolic between 80-90). The endocrinologist I see routinely does blood pressure checks every three months and has not expressed great concern in spite of some borderline readings in the past. However, I recently had a systolic reading above 140, although diastolic was below 90.

I have a slender build and am moderately active although pulse rates tend to be around 80-90 when not physically exerted. Stress levels are often high because of work and other factors. Blood sugar control has been generally good according to my doctor, with hemoglobin A1c levels around 7-7.4%.

I am wondering if this is any cause for concern. Are any of these things unusual given the situation I have described? I did not believe high blood pressure was common at my age, and I am hoping that the "borderline" levels are common or acceptable given the situation.

Answer:

Because the complications of diabetes involve blood vessels, even mild increases in blood pressure over a long time are of a concern. Clinical trials have shown that fewer complications occur with lower blood pressure targets. The American Diabetes Association has recommended that blood pressure should be treated if it rises to levels grater than 130/80 mm Hg. With values of 140/90, I would suggest you are a target for therapy. Therapy with an ACE inhibitor would be my choice as a first-line agent. These agents have shown to have benefit in protecting the eyes and kidneys in patients with type 1 diabetes.

JTL

[Editor's comment: Also, see How to Protect your Kidneys at the Diabetes Monitor. WWQ]

DTQ-20021005151934
Original posting 16 Oct 2002
Posted to Complications

  
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Last Updated: Tuesday April 06, 2010 15:09:38
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