Understanding hypertension and insulin

As Jamaica continues to battle a growing epidemic of non-communicable diseases, the conversation around hypertension and diabetes is evolving beyond symptoms to deeper, underlying causes.

Leading that shift is Dr Orlando Thomas, a medical doctor, educator, and founder of the Thomas Medical and Shockwave Centre in Old Harbour, who has been using his YouTube platform to unpack the complex relationship between insulin and high blood pressure.

In a recent livestream, Dr Thomas challenged conventional thinking, urging Jamaicans to look beyond surface-level diagnoses. “Insulin is not just about diabetes.It is a central hormone that affects multiple systems in the body. When insulin is dysregulated, it creates a cascade of problems, including hypertension,” he said.

Insulin is responsible for helping glucose enter the body’s cells to be used as energy. However, when the body becomes resistant to insulin, a condition known as insulin resistance, the pancreas compensates by producing more of the hormone. Over time, this leads to chronically elevated insulin levels, which Dr Thomas says plays a direct role in raising blood pressure.

“High insulin levels cause the kidneys to retain sodium and water, which increases blood volume and raises blood pressure. It also contributes to the stiffening of blood vessels and increased inflammation, which further compounds the problem,” he said.

This physiological connection is particularly concerning in Jamaica, where both hypertension and diabetes are widespread. Data from the Ministry of Health & Wellness Jamaica indicate that approximately one in four Jamaican adults has hypertension, while diabetes affects an estimated 8 to 12 per cent of the population.

Even more alarming is the level of underdiagnosis and poor control, with many individuals unaware of their condition until complications arise. Non-communicable diseases account for nearly 70 per cent of all deaths in Jamaica, with cardiovascular disease and stroke leading the statistics.

Dr Thomas emphasised that insulin resistance often develops silently, sometimes decades before a formal diagnosis. “By the time someone is diagnosed with diabetes, they have likely been insulin resistant for years. Hypertension often develops along that same timeline, which is why we see these conditions occurring together so frequently,” he said.

He also highlighted the role of visceral fat- fat stored around internal organs - as a major driver of insulin resistance. “This is not just about weight. It is about where the fat is distributed. Visceral fat is metabolically active and releases inflammatory chemicals that worsen insulin resistance and damage blood vessels,” he said.

In his presentation, Dr Thomas pointed to modern lifestyle patterns as key contributors. Diets high in refined carbohydrates, sugary drinks, and ultra-processed foods continuously spike insulin levels, eventually overwhelming the body’s regulatory systems. “We are constantly stimulating insulin with what we eat. If the body never gets a break, it loses its sensitivity to insulin,” he said.

Beyond diet, chronic stress is another major factor. Elevated cortisol levels, often triggered by prolonged stress, can increase blood sugar and worsen insulin resistance. Poor sleep further compounds the issue, disrupting hormonal balance and increasing the risk of both hypertension and metabolic disease.

Dr Thomas is particularly passionate about shifting the focus from treatment to prevention. “We have normalised managing disease instead of preventing it, but these conditions are largely lifestyle-driven, which means they are also modifiable,”

He advocates for a multilayered approach that includes dietary changes, increased physical activity, stress reduction, and improved sleep hygiene. Diets rich in whole foods, including vegetables, lean proteins, and healthy fats, help stabilise blood sugar and reduce insulin spikes. Regular exercise enhances insulin sensitivity, allowing the body to use glucose more efficiently.

Importantly, he stressed that small, consistent changes can have a profound impact. “You don’t have to be perfect, but you have to be intentional. Every positive choice moves you closer to better health,” he said.

The implications of his message are far-reaching, particularly in underserved communities where access to healthcare may be limited. Through his digital outreach, Dr Thomas is bridging that gap, bringing critical health education directly to the public.

He also underscored the importance of routine screening. “Check your blood pressure, check your blood sugar, know your numbers. Early detection gives you the opportunity to intervene before complications set in,” Dr Thomas said.

For many Jamaicans, hypertension remains a silent threat, often going unnoticed until it leads to serious outcomes such as heart attacks, strokes, or kidney failure. When combined with insulin resistance, the risks multiply significantly.

Dr Thomas believes that education is the most powerful tool in reversing this trend. “When people understand what is happening in their bodies, they are more empowered to make better decisions. Health is not just about medication. It is about knowledge, discipline, and daily habits,” he said.

The link between insulin and hypertension is not just a medical concept. It is a call to action. In a country facing a rising tide of chronic illness, addressing the root causes may be the key to building a healthier future.

“Your lifestyle is either feeding disease or fighting it. The choice is yours,” Dr Thomas said.

keisha.hill@gleanerjm.com