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High Blood Pressure and Kidney Disease

High Blood Pressure and Kidney Disease

High blood pressure (hypertension) is a leading cause of kidney disease and kidney failure (end-stage renal disease).
Hypertension can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult. Once a person is diagnosed with end-stage renal disease, dialysis — a blood-cleansing process — or kidney transplantation are necessary.

What Are the Symptoms of Kidney Disease?

The symptoms of kidney disease include:

How Is Kidney Disease Diagnosed?

As with high blood pressure, you may not realize that you have kidney disease. Certain laboratory tests can indicate whether your kidneys are eliminating waste products properly. These tests include serum creatinine and blood urea nitrogen (BUN); elevated levels of either can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.

Who Is At Risk for Kidney Disease Due to High Blood Pressure?

Kidney disease caused by high blood pressure affects every group and race. However, certain groups are at higher risk, including:

How Can I Prevent Kidney Disease?

To prevent kidney damage from high blood pressure:

How Is Kidney Disease Treated?

For patients who have high blood pressure and kidney disease, the most important treatment is to control your blood pressure through lifestyle changes. ACE inhibitor and angiotensin II receptor blocker (ARB) drugs lower blood pressure and can protect the kidneys from further damage, but treatments need to be individualized.

High Blood Pressure and Eye Disease

Along with causing heart and kidney problems, untreated high blood pressure can also affect your eyesight and lead to eye disease. Hypertension can cause damage to the blood vessels in the retina, the area at the back of the eye where images focus. This eye disease is known as hypertensive retinopathy. The damage can be serious if hypertension is not treated.

What Are the Symptoms of Hypertensive Retinopathy?

A person typically won’t experience symptoms of mild to moderate hypertensive retinopathy; it is usually discovered during a routine eye exam. Symptoms of more severe and accelerated hypertension might include headaches and vision problems.
Severe retinopathy can occur alongside high blood pressure during pregnancy, so prenatal care is important.

How Is Hypertensive Retinopathy Diagnosed?

An eye care professional can diagnose hypertensive retinopathy. Using an ophthalmoscope, an instrument that projects light to examine the back of the eyeball, the doctor will look for signs of retinopathy that include:

How Is Hypertensive Retinopathy Treated?

The best way to treat hypertensive retinopathy is to adequately control your blood pressure.

Can Hypertensive Retinopathy Be Prevented?

To prevent hypertensive retinopathy, keep your blood pressure under control by reaching and maintaining your optimal weight, sticking with a diet recommended by your physician, exercising regularly, and faithfully taking your high blood pressure medications as prescribed. In addition, see your doctor on a regular basis for follow-up care.

Diabetes and High Blood Pressure

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High blood pressure (hypertension) can lead to many complications of diabetes, including diabetic eye disease and kidney disease, or make them worse. Most people with diabetes will eventually have high blood pressure, along with other heart and circulation problems.
Diabetes damages arteries and makes them targets for hardening, called atherosclerosis. That can cause high blood pressure, which if not treated, can lead to trouble including blood vessel damage, heart attack, and kidney failure.

Compared to those with normal blood pressure readings, people with hypertension more often have:

Even blood pressure that’s at the higher end of normal (120/80 to 129/80), called elevated, impacts your health. Studies show that you have a two to three times greater chance of getting heart disease over 10 years.

What Should Your Blood Pressure Be?

Readings vary, but most people with diabetes should have a blood pressure of no more than 130/80.
The first, or top, number is the “systolic pressure,” or the pressure in your arteries when your heart squeezes and fills the vessels with blood. The second, or bottom, number is the “diastolic pressure,” or the pressure in your arteries when your heart rests between beats, filling itself with blood for the next contraction.
When it comes to preventing diabetes complications, normal blood pressure is as important as good control of your blood sugar levels.

Symptoms of High Blood Pressure

Usually, high blood pressure has no symptoms. That’s why you need to check your blood pressure regularly. Your doctor will probably measure it at every visit, and you may need to check it at home, too.

What Can You Do?

Many of the things you do for your diabetes will also help with high blood pressure:

Treatment

Most doctors use ACE inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) first. Although other medications treat high blood pressure, these also prevent or slow kidney disease in people with diabetes.
Some blood pressure drugs may make your blood sugar and lipid levels worse. Blood pressure medicines can also cause erectile dysfunction. Find out from your doctor what your prescribed medicines might do.
Other drugs known commonly as “water pills” or diuretics help your body get rid of extra fluid.

How High Blood Pressure Leads to Erectile Dysfunction

To understand how high blood pressure can lead to erectile dysfunction, you first have to understand how erections work. Getting an erection is really a complicated process.

Anatomy of an Erection

In the shaft of the penis there are two side-by-side chambers of spongy tissue called the corpora cavernosa. They’re mainly responsible for erections. Just below them is another chamber called the corpus spongiosum. The urethra, which carries semen and urine, runs through the center of it.
The corpora cavernosa are made of small arteries and veins, smooth muscle fiber, and empty spaces. The chambers are wrapped in a sheath of thin tissue.
When you get an erection, signals from the brain or nerve endings in the penis cause the smooth muscle of the chambers to relax and arteries to dilate, or open wider. This allows a rush of blood to fill the empty spaces.
The pressure of blood flow causes the sheath of tissue around the chambers to press on veins that normally drain blood out of the penis. That traps blood in the penis. As more blood flows in, the penis expands and stiffens, and you have an erection.
When the excitement ends, the smooth muscle contracts again, taking pressure off the veins and allowing blood to flow back out of the penis. Then the penis returns to a flaccid state.

High Blood Pressure and Other Causes of Erectile Dysfunction

High blood pressure is a major cause of erection problems. A study in the Journal of the American Geriatrics Society found that about 49% of men ages 40 to 79 with high blood pressure had erectile dysfunction.
Another study of men with high blood pressure, published in the Journal of Urology, found that 68% of them had some degree of erectile dysfunction. For 45% of the men, it was considered severe.
High blood pressure keeps the arteries that carry blood into the penis from dilating the way they’re supposed to. It also makes the smooth muscle in the penis lose its ability to relax. As a result, not enough blood flows into the penis to make it erect.
Men with high blood pressure may also have a low testosterone level. Testosterone is the male hormone that plays a big role in sexual arousal.
High blood pressure by itself can lead to erectile dysfunction. But some drugs for treating high blood pressure can actually be the cause as well.
Diuretics — or water pills — and beta-blockers are the high blood pressure drugs most commonly linked to erectile dysfunction.
Diuretics may cause erectile dysfunction by decreasing the force of blood flow into the penis. They may also decrease the amount of zinc in the body. Your body needs zinc to make testosterone.
Beta-blockers dampen the response to nerve impulses that lead to an erection. They also make it more difficult for the arteries in the penis to widen and let in blood. What’s more, they can make you feel sedated and depressed — and the mind always plays some part in sexual arousal.
Sometimes, the choices that some men with high blood pressure make can add to the problem. Smoking, especially, is one of those. Smoking increases blood pressure, and damages blood vessels and reduces blood flow all around the body.
The power to take control of your blood pressure and sexual health is in your hands. By living a healthy lifestyle and working with your doctor, there’s a chance you’ll once again be able to have normal sexual function.

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