Common Blood Pressure Medications For People With Diabetes


Diabetes Canada and Hypertension Canada both recommend a blood pressure of less than 130/80 mmHg for people with diabetes. If you have diabetes and a blood pressure above 120/80 mmHg, it is never too early to make lifestyle changes to lower it. If you have diabetes and a blood pressure of 130/80 mmHg or higher, you will probably need to take blood pressure medications, in addition to making lifestyle changes, to bring it down to a healthy level.

Hypertension is often called “the silent killer” as it has no warning signs or symptoms and can only be diagnosed through blood pressure measurement. It can affect anyone and is more common as we get older. This is why it’s so important to have your blood pressure checked regularly. Many pharmacies have blood pressure stations where you can check your blood pressure. You can also purchase a blood pressure monitor to use at home.

What medications are used to treat hypertension?

If lifestyle changes alone cannot bring your blood pressure down to safe levels, you may need to start taking one or more medications. Here are a few commonly prescribed high blood pressure medications for people with diabetes.

Angiotensin-converting enzyme (ACE) inhibitors

The most commonly used medications to lower blood pressure in people with diabetes are ACE inhibitors. (Their names usually end in ‘pril’ and examples include ramipril and enalapril.) ACE inhibitors help the body produce less angiotensin, which helps the blood vessels relax and open up; this in turn lowers blood pressure. These medications work in the kidney to lower blood pressure. But they can also slow down kidney damage that high blood sugar can cause. If you’re taking an ACE inhibitor, your healthcare team will run blood tests to monitor the health of your kidneys.

Some possible side effects include:

  • Skin rash
  • Loss of taste
  • Chronic dry, hacking cough
  • If you’re taking an ACE inhibitor and think you might be pregnant, contact your healthcare team immediately. These drugs are dangerous to both mother and baby during pregnancy.

Angiotensin II receptor blockers (ARBs) 

Another common class of medication used to reduce blood pressure is ARBs. (Their names usually end in ‘sartan’ and examples include candesartan and valsartan.) This class of drugs block the effects of angiotensin, a chemical that causes the arteries to become narrow, meaning the blood vessels stay open and blood pressure is reduced.

Some possible side effects include:

  • Dizziness
  • ARBs should not be used during pregnancy. Medications that act directly on the renin-angiotensin system can cause injury or even death to a developing fetus. When pregnancy is detected, consult your healthcare team as soon as possible.

Calcium channel blockers (CCBs)

Calcium channel blockers also work well to lower blood pressure in people with diabetes. Examples include amlodipine, diltiazem, felodipine, nifedipine and verapamil. These medications prevent calcium from entering the cells of the heart and blood vessels. This relaxes the muscles in the heart and blood vessels, and lowers blood pressure. If someone is already on an ACE inhibitor but needs additional blood pressure lowering medication, a CCB is the preferred add-on therapy. People usually tolerate CCBs without issue; however, in rare cases, they can cause swelling of the feet and lower legs. If this happens, be sure to consult your healthcare team.

Some possible side effects include:

  • Heart palpitations
  • Swollen ankles
  • Constipation
  • Headache
  • Dizziness

Diuretics

Diuretics help the body get rid of excess sodium (salt) and water, while also widening the blood vessels. Together, these effects help control blood pressure. They are often used in combination with other prescription therapies. A commonly used medication in this class is hydrochlorothiazide.

Some possible side effects include:

  • Dizziness
  • Low potassium levels
  • Headaches
  • Dehydration
  • Muscle cramps
  • Joint disorders (such as gout)
  • Impotence

Beta blockers 

Beta blockers cause your heart to beat more slowly and with less force, which lowers blood pressure. Beta blockers also help open up your veins and arteries to improve blood flow. (Their names usually end in ‘olol’ and examples include metoprolol and atenolol.)

Some possible side effects include:

  • Dizziness
  • Constipation
  • Sleep disturbances

Trouble breathing, particularly if you have asthma



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