or high blood pressure, is often referred to as the silent killer. It
is the second most common cause of kidney disease in this country, and a
leading cause among African Americans. Hypertension affects many organs
of the body, including the heart, brain, blood vessels, and kidneys.
pressure measurements that are obtained in the doctor's office are used
as an initial guide to determine how severe your blood pressure is. As
you may be aware, the top number on the blood pressure is referred to as
the systolic (siss-tollik) blood pressure. The bottom number is called
the diastolic (dye-a-stollic) blood pressure.
doctors do pay attention to the lower number, it is the top number -
the systolic blood pressure - that really increases the risk of heart
disease, stroke, and kidney disease, especially as we get older. Your
doctor will ask you to take your blood pressure at home and record it,
as well, because for many patients, being in the doctor's office can
cause a rapid elevation in the blood pressure numbers, termed
How Hypertension Affects the Kidneys
kidneys and other body organs are designed to handle blood pressures
within a normal range. If the pressure delivered to them stays high over
a prolonged period of time, it can have harmful effects on the body's
systems. For example, heart disease and congestive heart failure are
long-term consequences of uncontrolled high blood pressure. In the
brain, hypertension is an important risk factor for stroke.
The kidneys also do not tolerate the stress of high blood pressure.
Uncontrolled high blood pressure causes inflammatory changes in the
blood vessels. Over time, the arteries begin to become sclerosed
(skler-ost) or scarred, which is called atherosclerosis. Left unchecked and untreated, hypertension can cause fibrosis - irreversible scarring - to the kidneys.
The Stages of The Different Hypertension
you may know from visits to the doctor's office or from surfing the
Internet, there are different stages of hypertension, depending on blood
pressure level. In 2003, a group of expert panelists and physicians
basically redefined hypertension and emphasized a focus on early
treatment and management even before high blood pressure is diagnosed.
The Seventh Report of the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure (commonly
referred to as JNC 7) were, in my opinion, ingenious in defining the new
classes of high blood pressure.
normal blood pressure is now defined as a systolic blood pressure (the
top number) of 120 or less, and/or a diastolic blood pressure (the lower
number) of 70 or less. The next stage, which is called prehypertension,
is defined by a systolic blood pressure of 120 to 139 and/or a
diastolic blood pressure of 80 to 89. This stage is very important,
because it is an excellent time to not only adopt lifestyle changes that
reduce the risk of developing hypertension, but also to focus on other
risk factors that may be present, including diabetes or prediabetes,
obesity, high cholesterol levels, a smoking habit, a sedentary
lifestyle, and poor dietary habits. It is no surprise that all of those
factors are risk factors for worsening kidney disease, as well; nor is
it a surprise that many of the conditions occur together.
this new classification scheme, there are two stages of hypertension,
stage 1 and stage 2. Stage 1 defines a systolic blood pressure as 140 to
159 and/or a diastolic blood pressure of 90 to 99. In stage 2, the
systolic blood pressure is 160 or higher and/or the diastolic 100 or
medication is usually prescribed at this stage. If you have stage 2
hypertension, two or more medications may be needed.
Standard Treatment Approaches
changes are the most important changes you can make for your kidney -
and your own - health. By exercising, stopping smoking,
lowering the amount of sodium in your diet, and losing weight (if
needed), you can lower your systolic and diastolic blood pressures,
perhaps without even needing to take any medication in the first place.
These are very real things that you can do that can help maintain and
improve your kidney health.
are also many classes of medication that your doctor may choose from in
treating hypertension. The following information includes key points
regarding a few classes of blood pressure medication. Talk with your
doctors regarding your treatment options. To find out more, you can check out Hypertension And Kidney Disease.