High blood pressure, also called hypertension, is common in people with type 1 or type 2 diabetes. In fact, people with diabetes are twice as likely to have high blood pressure as people without diabetes.
What is high blood pressure?
Blood pressure is the pressure, or force, of blood pushing against your artery walls. High blood pressure, then, is blood pressure that is higher than normal. High blood pressure puts you at risk for serious health problems, such as heart disease, heart attack, stroke, eye problems, and kidney disease.
How is blood pressure measured?
You’ve likely had your blood pressure measured at your provider’s office many times with a blood pressure cuff. Blood pressure is measured using two numbers:
Systolic blood pressure
This is the “top” number and is a measure of the pressure in your arteries when your heart beats. For example, 130.
Diastolic blood pressure
This is the “bottom” number and is a measure of the pressure in your arteries when your heart is relaxing between beats. For example, 85.
With these examples, blood pressure is written as 130/85 mm Hg (millimeters of mercury) and is said to be “130 over 85.”
Blood pressure chart: What’s normal blood pressure and high blood pressure?
Blood pressure readings fall into five categories, ranging from normal to extremely high (called “hypertensive crisis”), according to the American Heart Association.
| Blood Pressure Category | Systolic (Top) Number mm Hg | and/or | Diastolic (Bottom) Number mm Hg |
| Normal | Less than 120 | and | Less than 80 |
| Elevated | 120-129 | and | Less than 80 |
| Stage 1 high blood pressure | 130-139 | or | 80-89 |
| Stage 2 high blood pressure | 140 or higher | or | 90 or higher |
| Hypertensive Crisis | Higher than 180 | and/or | Higher than 120 |
Blood pressure chart source: American Heart Association
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What do the different blood pressure categories mean?
Normal
A blood pressure of less than 120/80 is considered to be normal, or safe. Keep up the good work by continuing to eat healthfully, be active, and stay at a healthy weight.
Elevated
Blood pressure readings are consistently 120-129 over 80 or less. Take further steps to eat more fruits and vegetables, for example, or cut back on sodium. Stopping smoking, drinking less alcohol, and/or aiming to be active most days of the week are lifestyle strategies that you can adopt.
Stage 1 high blood pressure
Blood pressure readings are consistently ranging from 130-139 over 80-89. Along with lifestyle changes, your provider will likely prescribe blood pressure medicine, based on your risk of heart disease. Keep in mind that people with diabetes are at higher risk of heart disease than people without diabetes.
Stage 2 high blood pressure
Blood pressure readings are consistently running 140/90 or higher. At this stage your provider will likely prescribe a combination of blood pressure medicines.
Hypertensive crisis
A hypertensive crisis is extremely serious and is when your blood pressure rises quickly and severely to 180/120 or higher. Blood pressure levels this high can lead to:
- Stroke
- Heart attack
- Aortic dissection (tears in the wall of the aorta)
- Damage to the eyes and kidneys
- Loss of consciousness
- Pulmonary edema (fluid in the lungs)
There are two categories of hypertensive crisis: urgent and emergency.
- With an urgent hypertensive crisis, your blood pressure spikes very high but you aren’t having symptoms of possible organ damage, such as shortness of breath, chest pain, severe headache, or seizures.
- With an emergency hypertensive crisis, your blood pressure spikes very high and you have possible life-threatening symptoms, such as chest pain, shortness of breath, severe headache, loss of consciousness, seizures, or changes in vision.
Factors or conditions that put you at risk of a hypertensive crisis are:
- Not taking your blood pressure medicine
- Smoking
- Alcohol or drug abuse
- Kidney disease
- Some medicines, such as birth control pills and monoamine oxidase inhibitors
- Preeclampsia, a condition that occurs during and sometimes after pregnancy
- Central nervous system disorders
- Lupus
- Scleroderma
- Cushing disease
Older adults and African Americans are at an increased risk of developing a hypertensive crisis.
What’s your blood pressure target?
The American Diabetes Association’s Standards of Medical Care in Diabetes — 2021 states that blood pressure targets should be “individualized through a shared decision-making process” that takes into account your risk of heart disease, possible adverse effects of blood pressure medicine, and patient preference. In general, blood pressure targets for people with diabetes are:
- Less than 130/80 if at high risk of heart disease
- Less than 140/80 if at lower risk of heart disease
- 110-135/85 for pregnant women with high blood pressure
Talk with your provider about your own target, as well as the best treatment options for you.
Want to learn more about diabetes and blood pressure? Read “Treating High Blood Pressure.”
