Blood Pressure Complications

High blood pressure damages blood vessels and, when combined with chronically high blood glucose, can increase the risk of complications. The American Diabetes Association recommends that people with Diabetes maintain blood pressures of less than 140/90 mmHg.

High blood pressure

Your blood pressure can be controlled through:

  • Medication (several may be needed)
  • Exercise
  • Stress reduction
  • Salt restriction
  • Weight loss
When you have Diabetes, the preferred classes of medications for the treatment of high blood pressure are angiotensin converting enzyme inhibitors (ACE) and angiotensin receptor inhibitors (ARBS). A common side effect of ACE inhibitor drugs is a dry cough, and both ACEs and ARBs may cause your body to retain too much potassium and raise your creatinine. Testing your blood for increased potassium and creatinine is recommended after starting these medicines. Talk with your medical provider about which blood pressure medication is best for you, and how to monitor if the pill is working properly.

Medicines for the treatment of high blood pressure


Angiotensin converting enzyme (ACE) inhibitors- Work by interfering with the renin-angiotensin system (RAAS). RAAS is a complex system responsible for regulating the body's blood pressure. They prevent ACE from producing angiotensin II, a substance that narrows blood vessels which then reduces blood pressure.
• Captopril (Capoten)
• Enalapril (Vasotec)
• Benazepril (Lotensin)
• Lisinopril (Prinivil, Zestril)
• Quinapril (Accupril)
• Ramipril (Altace)
• Trandolapril (Mavik)

Angiotensin receptor blockers (ARBs) - Work by interfering with the renin-angiotensin system (RAAS). RAAS is a complex system responsible for regulating the body's blood pressure. They block the receptor that angiotensin II, a substance that narrows blood vessels, binds to, blocking its action which then reduces blood pressure
• Losartan (Cozaar)
• Valsartan (Diovan)
• Olmesartan (Benicar)
• Irbesartan (Avapro)
• Candesartan (Atacand)
• Telmisartan (Micardis)

Beta blockers - Work on blood vessel walls, blocking the action of the sympathetic nervous system, which then reduces blood pressure
• Metoprolol tartrate (Lopressor)
• Metoprolol succinate (Toprol XL)
• Atenolol (Tenormin)
• Bisoprolol (Zebeta)
• Propranolol (Inderal)
• Carvedilol (Coreg)

Diuretics - Reduce blood pressure by increasing the amount of salt and water removed by the kidney
• Hydrochlorothiazide (HCTZ)
• Chlorthalidone (Hygroton)
• Furosemide (Lasix)
• Bumetanide (Bumex)
• Torsemide (Demadex)
• Spironolactone (Aldactone)

Calcium channel blockers - Work on the smooth muscles of the blood vessels, making them relax which then reduces blood pressure
• Amlodipine (Norvasc)
• Nifedipine (Adalat, Procardia)
• Diltiazem (Cardizem)
• Verapamil (Calan, Isoptin)

Alpha blockers - Work on the blood vessel walls, causing the blood vessels to dilate which then reduces blood pressure
• Doxazosin (Cardura)
• Terazosin (Hytrin)
• Prazosin (Minipress)

Central alpha agonist - Work in the central nervous system inhibiting the sympathetic system
• Clonidine (Catapres)

Direct vasodilators - Directly bind and relax smooth muscles in blood vessels, causing vessels to dilate which then reduces blood pressure
• Hydralazine (Apresoline)
• Minoxidil (Loniten)

Reproduced from Whelton et al. “2017 ACC/AHA/AAPA/ABC/ACPM/ AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults”.