Having diabetes and high blood pressure can increase your risk for stroke and heart attack. These lifestyle changes can help lower your chances of heart problems and improve your overall health.

There are many numbers to keep track of when you have type 2 diabetes — such as your blood sugar, cholesterol, and A1C, which shows how well you control your blood sugar on average over time. But another important number you need to know is your blood pressure. That’s because two of every three people with diabetes also have high blood pressure, according to the American Diabetes Association (ADA).

High blood pressure means your blood is moving through your blood vessels with excess force. As a result, your heart has to work harder, putting you at risk for stroke and heart attack. Narrowed blood vessels due to high blood pressure can also increase your risk for kidney disease and eye problems, two common complications of diabetes.

The Link Between Diabetes and High Blood Pressure

Diabetes raises your risk for high blood pressure because diabetes can damage blood vessels, says Shelley Wishnick, RD, CDN, CDE, a clinical nutrition coordinator and diabetes educator at Mount Sinai Diabetes Center in New York. “It is more difficult for blood to flow through damaged arteries, which can lead to high blood pressure.”

High blood pressure is often called “the silent killer” because it can have no symptoms. That’s why it is important to monitor your blood pressure if you have diabetes.

How to Monitor Your Blood Pressure

The first place to turn for a blood pressure reading is your doctor’s office. “Have your blood pressure checked at every medical visit,” says David Lam, MD, an assistant professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai in New York. Depending on how often you visit your doctor or endocrinologist, that could be every three months or it could be once a year, Dr. Lam says. Some people may need to monitor their blood pressure at home more frequently, especially if they’re changing medications to control it. "You don’t want to wait three months to find out if the medications are working to lower your blood pressure," Lam adds.

Blood pressure is measured in millimeters of mercury (mmHg). The goal for most people with diabetes is a blood pressure reading of less than 140/90 mmHg, according to the ADA. The top number is the systolic pressure, measured as your heart beats and pushes blood through the vessels. The bottom number is the diastolic pressure, which tells you what your pressure is between beats when your vessels relax. A pressure greater than 140/90 mmHg is considered high and should be treated, the ADA says.

You need to work with your doctor if you have high blood pressure because it won’t go away on its own. In addition to medication, there are lifestyle changes you can make to help lower your blood pressure. As an added bonus, these changes will also help you manage your diabetes.

Lifestyle Changes to Control Blood Pressure

Steps you can take to lower blood pressure and better control diabetes include:

Maintain a healthy weight. If you are overweight, lose weight. “Even losing 10 pounds will make a big difference in blood pressure and other health parameters,” says Tami Ross, RD, LD, CDE, of Lexington, Kentucky, author of What Do I Eat Now? A Step-by-Step Guide to Eating Right With Type 2 Diabetes. Weight gain puts strain on your heart. Excess fat also causes you to release hormones that can cause your blood pressure to rise, according to the Joslin Diabetes Center.

Watch your salt intake. Ideally, you want to eat no more than a teaspoon of salt a day, Ross says. Excess salt can cause your body to retain water, and water retention can lead to high blood pressure. One of the easiest ways to cut salt is to cut processed foods from your diet, Ross says. Eating home-cooked meals instead of restaurant food can also help you have greater control over your salt intake.

Quit smoking. Diabetes raises your risk for heart disease, Wishnick says, and so does smoking. Each cigarette you smoke increases your blood pressure while you inhale and for a few minutes after, according to the American Heart Association (AHA). “Stopping smoking can have a positive impact on cardiovascular health for people with diabetes,” Wishnick says.

Get regular exercise. “Each time you exercise, it lowers your blood pressure for 24 hours,” Ross says. “It’s like extended-release medicine.” Exercise also helps your body use insulin more effectively and can lower your blood sugar, according to the National Institutes of Health. Aim for a minimum of 30 minutes of exercise at least five times a week, Ross says.

Reduce stress. Stress not only elevates blood pressure but also can elevate blood sugar, Ross says. Stress inhibits the body’s ability to release insulin, which can lead to glucose piling up in the blood, according to the ADA. Ways to reduce stress include exercise, meditation, yoga, and other relaxing activities you enjoy.

You might still need medication in addition to these lifestyle interventions, Lam says, but a healthy lifestyle does make a difference. These changes can greatly help with managing blood pressure and diabetes, too.