High Blood Pressure (Hypertension)

Kidney Disease

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One in every three U.S. adults has high blood pressure. High blood pressure is the second leading cause of chronic kidney disease (CKD). In fact, one out of four kidney failure cases are from high blood pressure. There are things that you can do to help keep your blood pressure in a healthy range. This can reduce your risk for kidney disease.

What is blood pressure?
How does blood pressure affect my kidneys?
How do my kidneys affect my blood pressure?
How is blood pressure measured?
What do my blood pressure numbers mean?
What can I do to control my blood pressure?
What can I do if I already have kidney disease?
More Information

What is blood pressure?

When blood flows through your body, it presses on the walls of your blood vessels. This force is called blood pressure. Blood pressure that is too high makes the heart work harder and can damage blood vessels in the body. If left untreated, high blood pressure (called hypertension) can lead to health problems, including:

kidney failure,
stroke,
heart attack and
heart failure.

Even worse, high blood pressure has NO symptoms. It is often called the “silent killer.” The only way to know if you have high blood pressure is to be checked.

How does blood pressure affect my kidneys?

High blood pressure can permanently damage tiny blood vessels in the kidneys’ nephrons (filtering units). Over time, this damage will keep your kidneys from working as well as they should. If blood pressure stays high, the damage will get worse and kidney function will continue to drop.

How do my kidneys affect my blood pressure?

Damaged kidneys can actually cause high blood pressure. One of the jobs of healthy kidneys is to control blood pressure. They do this by making a enzyme called rennin. When the kidneys are damaged, they cannot make renin as well as they should. This causes blood pressure to rise. The higher blood pressure can damage the kidneys even more.

How is blood pressure measured?

Checking blood pressure is quick and simple.
It can be done either with a blood pressure cuff and stethoscope or with an electronic monitor (machine).

You can have your blood pressure checked at your doctor’s office or at free screenings in the community. Another option is to get a blood pressure cuff and check your own blood pressure. You can even find easy-to-use blood pressure machines at grocery stores or local malls.

Sometimes, people have higher blood pressure at the doctor’s office and more normal blood pressure at other times. This is called “white coat syndrome”. If you think you might have this problem, you might want to try checking your blood pressure at home. Be sure to record your results so that you can show your doctor at your next visit.

What do my blood pressure numbers mean?

Blood pressure measures the amount of force on your arteries as your blood flows through them. When you get your blood pressure checked, your results will come back as two numbers. The first, or top number, is called systolic pressure. This is the pressure in your arteries when your heart contracts (beats). The second, or bottom number, is called diastolic pressure. This is the pressure in your arteries when your heart relaxes (between beats).

The numbers that you get from a blood pressure check will tell you if your blood pressure is healthy, a little high or very high. A healthy blood pressure is less than 120/80 or “120 over 80”. This table, from the National Heart, Lung and Blood Institute, can help you decide where your numbers fall.

Category	Systolic (Top number)	Diastolic (Bottom number)
Normal/Healthy	Less than 120	Less than 80
Prehypertension	120-139	80-89
High Blood Pressure Stage 1	140-159	90-99
High Blood Pressure Stage 2	160 or higher	100 or higher

Blood pressure changes when you do different activities, eat certain foods, and are stressed or excited. So, one blood pressure reading cannot show if you have high blood pressure. But, your blood pressure might be a problem if your numbers are high much or all of the time.

What can I do to control my blood pressure?

Check your blood pressure often. This will help you learn what is normal for your body and address high blood pressure before it causes other problems.
Exercise regularly. Getting 30 minutes of aerobic exercise (walking, running, dancing, biking, swimming, etc.) most days of the week will help to keep your blood pressure in a healthy range. Also, losing even a few pounds if you are overweight can help to lower your blood pressure.
Avoid tobacco products.
Avoid alcoholic drinks.
Talk to your doctor about starting a blood pressure medicine if you have high blood pressure. ACE Inhibitors and ARBs are two types of medicines that can help control blood pressure and prevent damage to the heart and kidneys.
Talk to your doctor about taking a diuretic (“water pill”) if you have high blood pressure. Extra fluid in your body can raise your blood pressure.

What can I do if I already have kidney disease?

If you already have kidney disease, it is very important to keep your blood pressure in a healthy range. This will help prevent further kidney damage. Make sure to:

keep your blood pressure lower than 130/80*
discuss a target blood pressure reading with your doctor
ask your doctor if an ACE inhibitor or ARB is right for you. These medicines can help control your blood pressure and slow the kidney disease.

*National Kidney Foundation. K/DOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease. American Journal of Kidney Diseases. 2004; 43:S1-S290.

Click here to order the brochure, "High Blood Pressure and the Kidneys," from the American Kidney Fund.