ANGINA/IF YOU HAVE DIABETES AS WELL: YOUR BLOOD PRESSURE TARGET

April 2nd, 2009 by admin

If you have diabetes as well as angina, then keeping your blood pressure under excellent control is even more important. Diabetes and hypertension go hand in hand; more people with diabetes than without it have hypertension. In people with both diseases, many have angina, and they are at much higher risk of a heart attack than everyone else. Treatment to lower their blood pressures is very much more effective at reducing their risks of heart attack and kidney failure than even the most rigorous control of their diabetes itself.

Your Blood Pressure Target

One of the first large studies of the results of blood-pressure lowering, the United Kingdom Medical Research Council Trial, concluded that in high-risk subjects (defined as those with mildly raised diastolic and a high systolic blood pressure, male, smokers, and people with a high blood cholesterol), treating the blood pressure would prevent one stroke per four patients over five years. In a low-risk person, with only a mildly raised diastolic pressure and no other risk factors, the saving would be one stroke per 242 patients in the same time period.

That trial used a combination of antihypertensive drugs that is now outdated, and has been superseded by newer drugs, so that treatment for hypertension is even more effective now, and with better chances of saving lives.

How far do you need to bring your blood pressure down? Studies show that lowering the average blood pressure by 6 to 8 mm Hg could reduce the incidence of coronary heart disease in the U.S. by 25 percent. This is true whether the initial blood pressure is extremely high or just moderately raised.

This finding was surprising to the researchers, who expected the benefit to be less in patients with less severe hypertension. It has meant that the target figures for a satisfactory blood pressure have been changed. The old target was a diastolic pressure of 90 mm Hg. Then it became 85 mm Hg. The current blood pressure target is 80 mm Hg or less, and the savings in illness and deaths continue to increase. It appears, for diastolic pressure, that the lower it is, the better.

You can lower your blood pressure to some extent by changing to the healthier lifestyle of good eating and exercise described earlier, but this is not enough for many people with angina and hypertension. These people also need blood pressure-lowering (antihypertensive) drugs.

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