Diabetes and high blood pressure (arterial hypertension) very often occur together. Around 70-80% of all people with type 2 diabetes and around 40% with type 1 diabetes also have elevated blood pressure. The combination of both diseases massively increases the risk of heart attacks, strokes, kidney damage and eye diseases.
Causes of the combination
The common origin has several reasons:
- Insulin resistance promotes vasoconstriction and sodium retention
- Chronic inflammation and oxidative stress damage the vessel wall
- Autonomic neuropathy disrupts blood pressure regulation
- Obesity, lack of exercise and a high-salt diet worsen both diseases
Why the combination is so dangerous
Diabetes + high blood pressure multiplies the risk:
- Cardiovascular diseases by 2 to 4 times
- Diabetic nephropathy (kidney damage) occurs significantly more quickly
- Diabetic retinopathy and macular edema more common and severe
Target values and therapy
The current guidelines recommend a blood pressure target of below 130/80 mmHg (if tolerated well). The therapy consists of:
- Lifestyle measures (weight loss, low-salt diet, regular exercise, not smoking)
- Drug treatment (ACE inhibitors or sartans are the first choice because they also protect the kidneys)
- Regular self-measurement at home
Further information:
→ Diabetes mellitus – knowledge and overview
→ Why hyporest
→ Type 2 diabetes
Sources
- German Diabetes Society (DDG). S3 guideline “Type 2 diabetes”. As of 2025. Available at: www.deutsche-diabetes-gesellschaft.de/leitlinien.
- American Diabetes Association. Standards of Medical Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). Available at: diabetesjournals.org.
- Robert Koch Institute (RKI). Federal health reporting – diabetes mellitus in Germany. Berlin 2024.
- International Diabetes Federation (IDF). IDF Diabetes Atlas. 11th edition. Brussels 2025. Available at: diabetesatlas.org.
Important note:
The information in this encyclopedia article is intended solely for general and non-binding information. They do not replace medical advice, diagnosis or therapy. If you have any health questions or complaints, please always consult a doctor or qualified healthcare professional. The content was created with the greatest possible care, but errors cannot be completely ruled out.
Last updated: February 26, 2026
