U.S. adults who have both high blood pressure (hypertension) and type 2 diabetes (T2D) face a much higher risk of dying from any cause, especially heart-related causes, than people who have only one or neither of these health problems.
That’s according to a new study from Columbia University’s Mailman School of Public Health, recently published in the journal Diabetes Care.
The study also shows that even people with prediabetes (higher than normal blood sugar) and slightly high blood pressure are at greater risk of dying compared to those with healthier levels.
High blood pressure affects nearly half of adults in the U.S., and this number is expected to reach 61% by 2050. About 15% of adults currently have type 2 diabetes, and over a third have prediabetes. Without lifestyle changes, more than half of those with prediabetes will go on to develop full-blown diabetes.
“There are more and more people in the U.S. living with both diabetes and high blood pressure,” says Dr. Nour Makarem, the study’s senior author. “That puts them at greater risk for heart disease and early death. We urgently need better public health strategies to prevent and manage these problems.”
Researchers looked at health data from nearly 49,000 adults who took part in a national health survey between 1999 and 2018. They grouped people based on whether they had no conditions, only high blood pressure, only diabetes, or both.
Over those two decades, the number of people with both conditions doubled from 6% to 12%. These individuals were more likely to be older, have lower income or education levels, and were more often Black or Hispanic.
The death rates showed stark differences. After about nine years of follow-up, one-third of people with both conditions had died. In comparison, 20% of those with diabetes only, 22% with high blood pressure only, and just 6% with neither had passed away.
Having both conditions doubled the risk of dying from any cause and tripled the risk of dying from heart disease. These risks were consistent across race and gender but were generally higher for women than men.
Even people with prediabetes and slightly high blood pressure faced up to a 19% greater risk of dying. This suggests that the danger starts before blood pressure or blood sugar levels reach the levels required for an official diagnosis.
Compared to people with only high blood pressure, those with both conditions had a 66% higher risk of dying from any cause and a 54% higher risk of dying from heart disease. Compared to people with only diabetes, those with both had a 25% higher all-cause death risk and more than double the risk of dying from heart disease.
These findings stress the importance of checking both blood pressure and blood sugar levels—especially in communities where heart and metabolic diseases are common.
The researchers suggest that better prevention and treatment strategies are needed. These should include support for taking medications correctly and adopting healthy habits.
“With the aging population and rising rates of chronic diseases in the U.S., we must act now,” said Dr. Makarem. “We need new public health policies that target several health risks at once and help people live longer, healthier lives.”
If you care about blood pressure, please read studies about This alcohol treatment could help treat high blood pressure and How blood pressure changes with age.
For more about blood pressure, please read studies about Intensive blood pressure treatment for older adults may harm heart and kidneys and What you should know about high blood pressure medications.
The study is published in Diabetes Care.
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