Q: I am a 65 years old male, diabetic for the past 22 years. Twice I was admitted in the hospital in accident cases. Many a times I went to the physician for checking of blood pressure. The maximum limit for diastolic comes 70-90 and systolic 130-150. Besides I have a blood pressure instrument at home, which also shows approximately the same results. My diabetologist is amazed that in spite of being diabetic for the last 22 years, I do not have high blood pressure. Is it necessary for a diabetic person to have hypertension?

A:I complement you for raising very important query. The issue is diabetes and hypertension (HT).

Hypertension is a silent disease and unless BP goes very high (>200 or so) patients remain asymptomatic. Hypertension affects 50-70% of diabetic patients and not all patients. There is something called as white coat hypertension which means that patient's BP rises when he visits a doctor. But there are other ways to find hypertension like retinal examination which in patients with long standing HT shows some changes.

The target BP in diabetic patients is less than normal population i.e., <130/80 (normal population 140/90). Also some of anti BP drugs are heart and kidney protective as well like Ramipril / ARBs.

In your case some of the readings are high therefore it will be beneficial for you to take medications.