High blood pressure is the second leading cause of kidney failure; 1 in 4 people with kidney failure have it because of high blood pressure.

What is high blood pressure?

Your heart pumps blood through tubes called your arteries and veins. This causes pressure inside of these tubes, which is called blood pressure. Checking your blood pressure tells you how hard your heart is working to pump your blood.

Blood pressure that is too high (hypertension) means your heart is working too hard to pump your blood. This can harm your body, including your kidneys. 

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How does high blood pressure cause kidney disease?

Your kidneys are made of tiny blood vessels that help clean your blood. When you have high blood pressure, the blood flows through these blood vessels with a lot of force. This can harm these blood vessels and cause kidney disease. However, high blood pressure can also be a symptom of kidney disease. Kidneys help your body control your blood pressure. When high blood pressure damages your kidneys, they cannot control your blood pressure very well. 

You will not be able to feel if high blood pressure has hurt your kidneys. The only way to know is to be tested. Learn more about the tests for kidney disease.

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How can I prevent kidney disease caused by high blood pressure?

It can take many years for high blood pressure to damage your kidneys. You can take steps to control your blood pressure and prevent kidney disease. If you already have kidney disease, controlling your blood pressure can help prevent more damage to your kidneys.

To prevent kidney disease or keep kidney damage from getting worse, you can:

  • Control your blood pressure
  • Eat healthy
  • Control your blood sugar if you have diabetes
  • Control your cholesterol  
  • Quit smoking or using tobacco
  • Limit alcohol
  • Stay at a healthy weight
  • Be active most days of the week

Control your blood pressure

Your doctor may ask you to check your blood pressure at home with a digital blood pressure monitor. Many pharmacies and grocery stores have in-store monitors that you can use for free. You can also get a monitor from your local drug store, hospital, clinic or online. Your doctor can help you find a monitor that is right for you and can show you how to use it.

When you check your blood pressure, your result will be two numbers. Both numbers are important:

  • The first (top) number is your systolic pressure. This is the pressure in your arteries and veins when your heart is beating and the pressure is at its highest.
  • The second (bottom) number is your diastolic pressure. This is the pressure in your arteries and veins when your heart is between beats and the pressure is at its lowest.

For most people a normal blood pressure is less than 120/80 mm Hg (120 over 80). This means that your systolic pressure should be 120 mm Hg or less and your diastolic pressure should be 80 mm Hg or less. If either number is too high, your blood pressure is high.

Ask your doctor what your blood pressure should be and how often you should have it checked or check it on your own. 

Eat healthy

What you eat and drink can change your blood pressure. Choose foods that are low in sodium (salt) and fat to help keep your blood pressure in a healthy range. Use these tips to get started:

  • Eat less sodium
    • Do not add salt to your food when cooking or eating. Try cooking with fresh herbs, lemon juice or spices.
    • Choose fresh or frozen vegetables instead of canned. If you do use canned vegetables, rinse them with water before eating or cooking to remove extra salt.
    • Shop for items that say “reduced-sodium” or “low-sodium.” If you have kidney disease, check that these items do not contain potassium instead of salt.
    • Limit processed foods, such as frozen dinners and lunch meats.
    • Limit fast food and salty snacks, such as chips, pretzels, and salted nuts.
    • Limit foods that are pickled or preserved, such as pickles and olives.
  • Eat less fat
    • Choose lean meats or fish. Remove the skin and trim the fat off your meats before you cook them.
    • Bake, grill or broil your foods instead of frying them.
    • Shop for fat-free or low-fat dairy products, salad dressing, and mayonnaise.
    • Try olive or canola oil instead of vegetable oil.
    • Choose egg whites or egg substitute instead of whole eggs.

A dietitian can help you create a plan for a heart-healthy diet to control your blood pressure. Medicare and private insurance plans may help pay for dietitian visits. Ask your doctor to help you find a dietitian in your area. 

Control your blood sugar if you have diabetes

Having both diabetes and high blood pressure can make you more likely to get kidney disease. If you have diabetes, work with your doctor to manage it. Learn more about diabetes and kidney disease. 

Control your cholesterol

Cholesterol is a waxy, fat-like substance in your blood. Having high cholesterol and high blood pressure can make you more likely to get kidney disease, heart disease or a stroke. High cholesterol can also make kidney disease get worse faster.

There are two types of cholesterol you should pay attention to: HDL (“good” cholesterol) and LDL (“bad” cholesterol). For most people, healthy cholesterol levels are:

  • Total cholesterol less than 200 mg/dL
  • HDL (“good” cholesterol) more than 40 mg/dL
  • LDL (“bad” cholesterol) less than 100 mg/dL

Your triglycerides are also important – these are a type of fat in your blood. For most people, a healthy triglyceride level is less than 150 mg/dL.

Talk with your doctor about what your cholesterol and triglycerides levels should be and how you can control them.

Quit smoking or using tobacco

Using tobacco (smoking or chewing) can make high blood pressure and kidney problems worse. If you use tobacco, quitting can help lower your chance of getting kidney disease or help keep your kidney disease from getting worse.

Limit alcohol

Drinking alcohol in large amounts can make your blood pressure go up. By drinking less, you can help keep your blood pressure under control. Here are healthy guidelines:

  • For men, no more than two drinks per day
  • For women, no more than one drink per day

Stay at a healthy weight

A healthy weight can help you control your blood pressure and lower your chances of getting kidney disease. Talk to your doctor about what a healthy weight is for you. If you are overweight, losing just a few pounds can make a big difference.

Be active most days of the week

Being active can help you control your blood pressure and cholesterol. It can also help relieve stress, another common cause of high blood pressure.

Set a goal to be active for at least 30 minutes, 5 days a week. 

If that seems like too much, start slowly and work your way up. You do not have to go to the gym! Try adding just a little more activity to your routine, such as:

  • Take the stairs instead of the elevator.
  • Go for a walk after dinner.
  • Look for fun activities that you enjoy, like dancing, swimming, or playing a sport.

Be sure to talk to your doctor before starting any exercise plan.

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How is high blood pressure treated?

If being more active, eating healthier, and other lifestyle changes are not enough to control your blood pressure, your doctor may tell you to take a blood pressure medicine. There are many types of blood pressure medicines and you may need to take more than one treat your high blood pressure.

There are two types of blood pressure medicines that can also help protect your kidneys and slow down kidney disease:

  • ACE inhibitor: angiotensin-converting enzyme inhibitor
  • ARB: angiotensin II receptor blocker

Your doctor might also ask you to take a diuretic, also called a water pill. This helps your body get rid of extra fluid, which can cause high blood pressure.

Be sure to take any medicine the way your doctor tells you to. Blood pressure medicines work best when you take them every day, even if you feel fine. If you have any side effects from your medicines, talk to your doctor. You may be able to take a different medicine that does not have those side effects.

If you have trouble remembering to take your medicines, try to:

  • Set an alarm to remind yourself
  • Use a pill box to keep your medicines organized
  • Take your medicines at the same time every day as part of your normal routine, such as when you brush your teeth or eat a meal 

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