If you are taking the CDCES or BC-ADM exam in 2023, these new blood pressure target recommendations and treatment interventions are important to know.

For all of us who serve people with diabetes, research suggests that these more intensive blood pressure targets will save lives and decrease CV and microvascular disease. By sharing this information with our colleagues and teams, we can be a part of improving outcomes and quality of life.

The following content summarizes the 2023 updated ADA guidelines as outlined in Standard 10 – Cardiovascular Disease and Risk Management.

New Hypertension Definition and Target of 130/80

• A person with diabetes who has a confirmed blood pressure reading of 130/80 or greater (with either a systolic reading greater than 130 or diastolic reading greater than 80) qualifies for antihypertensive drug therapy.
• The on-treatment target blood pressure goal is less than 130/80 if it can be safely attained.
• It is important to individualize blood pressure targets through shared decision-making process. Consider cardiovascular risk, potential adverse effects of antihypertensive medications, and individual preferences. 
• All people with diabetes and hypertension need to have a home blood pressure monitor for ongoing evaluation of treatment response.

Lowering Blood Pressure Saves Lives and Reduces CV Risk.

Randomized clinical trials have unequivocally demonstrated that getting blood pressure to target saves lives and reduces risk of cardiovascular and microvascular complications.

The recommendation to support a blood pressure goal of <130/80 in people with diabetes is consistent with guidelines from the American College of Cardiology and American Heart Association (20), the International Society of Hypertension (21), and the European Society of Cardiology (22).

Action Steps to Treat Hypertension

• Lifestyle interventions for people with blood pressure >120/80 include weight loss when indicated, a Dietary Approaches to Stop Hypertension (DASH)-style eating pattern including reducing sodium and increasing potassium intake, moderation of alcohol intake, and increased physical activity.
• Pharmacologic therapy is initiated for individuals with confirmed office-based blood pressure of 130/80 or greater to achieve the recommended blood pressure target of <130/80.
• Treat hypertension with drug classes demonstrated to reduce cardiovascular events in people with diabetes. ACE inhibitors or angiotensin receptor blockers (ARBs) are recommended first-line therapy for hypertension in people with diabetes and coronary artery disease and/or for those with a urinary-albumin-creatinine ratio of 30 mg/g or greater. (Do not combine ACE Inhibitors and ARBS)
• Monitor potassium levels and GFR for individuals treated with an ACE inhibitor, angiotensin receptor blocker, or diuretic.

Hypertension Medication Cheat Sheets

Keeping track of medications for hypertension and cholesterol can seem daunting. We have put together a Hypertension and Lipid Medication Cheat Sheet along with summary information for each class that is important to know for certification exams and is very useful in clinical practice. 

Hypertension and Lipid Medication Cheat Sheet

Blood Pressure Matters

Together, we can improve the quality of life and outcomes for people living with diabetes. Getting blood pressure to target is one of the most important interventions we can take to maintain health. Thank you for reading this article and advocating for the best evidence-based care.

Want to learn more about this question? Join us for our

Level 2 | ADA Standards of Care CE Course | 2.0 CEs

Updates air live between Feb. 2, 2023, at 11:30 am PST

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2023 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for healthcare professionals involved in diabetes care and education.

Objectives:

1. List significant changes and updates to the 2023 ADA Standards of Medical Care.
2. State 3 updates on new blood pressure and lipid goals.
3. Identify 5 key elements of the position statement.
4. Discuss how to apply the Standards in the clinical setting and in preparation for exam success.

Intended Audience:  This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with prediabetes, diabetes and other related conditions.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

Studying for the CDCES Exam? Enroll in our

CDCES Deluxe Prep Bundle | 30+ Online Courses + Bonus Items | 47 CEs

Included in this bundle

• Level 1 focuses on the fundamentals and introduces each topic area for the exam.
• Level 2 deep dives into the ADA Standards of Care, 
• Level 3 AKA Boot Camp is a more accelerated level that focuses on test simulation for finding the best answer to get you to the finish line of your study path.
• Technology Toolkit which gives information on pumps, sensors, and calculations,
• Test Taking Toolkit includes over 220 practice questions for test simulation plus a webinar where Coach Beverly provides test-taking tips based on her experience taking the certification exam six times. 
• ADCES Review Guide for the Diabetes Care and Education Specialist Exam – 5th Edition – Revised – The ADCES Review Guide is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam. This book includes 480 + multiple-choice questions and strategies for preparing for and taking the exam with an answer key with rationales for all questions! 
• Medication PocketCard – Our four-sided medication accordion Pocketcards were designed by Coach Beverly Thomassian to assist in clinical practice and exam preparation.
• Tote Bag

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