Drug Treatment for Hypertension
If after several weeks of changing your diet and habits, your blood pressure hasn’t been effectively controlled, the doctor may prescribe medicines. But some antihypertensive drugs may cause unwanted effects in people with Diabetes.
Some antihypertensive drugs affect blood sugar levels, for example: beta blockers and diuretics may raise blood sugar levels by slowing influx of the insulin produced in the pancreas and causing it to work more inefficiently. This will only affect people with Type 2 Diabetes, because people with type 1 Diabetes don’t produce insulin.
If you have Type 2 Diabetes and need to take diuretics and beta blockers, your doctor will be able to control your high blood sugar levels by readjusting your Diabetes treatment.
Beta-blockers can also cause insensitivity to the early symptoms of hypoglycemia (low blood sugar) therefore if you need insulin or oral hypoglycemic agents, but also need to use beta blockers, you need to monitor your blood glucose levels more frequently to avoid hypoglycemia, though rarely, beta-blockers can also prolong hypoglycemia reactions. Because beta-blockers have several potential adverse effects in people with Diabetes, doctors try to not use them in these patients, however, in some cases it’s necessary, such as with certain types of cardiovascular disease like coronary vessel contraction, where beta blockers are the best alternative, also these are the only type of antihypertensive drugs that have been shown to prolong life after a heart attack.
Some antihypertensive drugs may worsen some complications or conditions associated with Diabetes:
- Erectile dysfunction is a common complication in men with Diabetes. Some antihypertensive drugs may worsen this situation. Tell your doctor about any problems you may have with sexual dysfunction, before starting and while under an antihypertensive drugs regime.
- People with Diabetes in some cases also present high cholesterol and triglyceride levels. Diuretics, and beta-blockers can increase these levels in the short term.
- Peripheral vascular disease is caused by damage to the arteries (small and large), narrowing them and reducing blood flow. Certain types of beta-blockers may further deteriorate these arteries in patients with severe peripheral vascular disease. Statins are drugs that have proven very effective in controlling cholesterol levels and C-reactive protein, which are the main causes of heart attacks, making them an excellent alternative treatment.
- Diabetic nephropathy or kidney disease, can cause hypertension and this in turn can worsen the kidney disease. Due to this, patients with kidney diseases need to pay special care to their hypertension. Angiotensin converting enzyme inhibitors, or ACE inhibitors (captopril), are usually a good alternative for people with Diabetes, they usually also decrease kidney disease progression, but in some cases they may also increase potassium levels in these patients. Another drug that has proven to be an excellent renal protective and which also helps maintain hypertension levels under control, are angiotensin II (Losartan), which have also been shown to reverse the progression of Diabetic nephropathy in its early stages (microalbuminuria).
- Autonomic neuropathy is a complication of Diabetes that can incapacitate the nervous system to protect the body from low blood pressure. Patients with autonomic neuropathy should avoid drugs that interfere with the flow of certain chemicals in the autonomic nervous system.
Other metabolic problems in some people with Diabetes, can complicate hypertension treatment. Diuretics can reduce potassium or magnesium levels, which can affect heart rhythm. If this occurs, one will also need to take potassium and magnesium pills.