Blood Pressure & Kidneys

 


Millions of Indians have high blood pressure, but many are unaware they have this disorder. The only way to know if you have high blood pressure is to have it checked. There are usually no signs or symptoms till your pressure is too high. For this reason, it is important to have regular blood pressure check-up, especially if you have a family history or another risk factor for high blood pressure, like diabetes, overweight etc.

Did you know these facts about high blood pressure?

  • It is called a silent killer because you can have it for years without knowing it
     
  • It is a leading cause of heart attacks, strokes, chronic kidney disease and blindness
     
  • Controlling it greatly reduces the risk of these complications
     
  • Losing weight, exercising more, stopping smoking and cutting down on salt often help to control blood pressure.

What is blood pressure?

Blood pressure is the force of your blood pushing against the walls of your arteries. Blood is carried from the heart to all the body’s organs and tissues through vessels called arteries. Blood pressure is the pressure of the blood against the walls of these arteries as the heart pumps the blood around the body.

What is high blood pressure (Hypertension)?

High blood pressure (also known as hypertension) occurs when the force of blood against your arterial walls increases enough to cause damage. One high reading may not mean you have high blood pressure. Your diagnosis of high blood pressure must be confirmed on follow-up visits to your doctor or clinic.

How do we measure blood pressure?

Blood pressure can be measured using a variety of techniques but the standard method is using an arm cuff and a stethoscope. Blood pressure is recorded as two numbers. The number represents the systolic reading. This is the pressure in the arteries as the heart squeezes out blood during a beat. The bottom number represents the diastolic reading, which is the pressure of the blood in the arteries when heart relaxes before the next beat. For example, your reading might be 120/75 mm Hg, which is called as 120 over 75.

What is a normal blood pressure reading?

Since the distribution of blood pressure varies over the population and within individuals during any one day, there are no fixed rules about what blood pressure reading is “normal”, but the following figures can be a useful guide:

  • Normal blood pressure: less than 130/85 mm Hg
     
  • Borderline: between 130/85 mm Hg and 140/90 mm Hg
     
  • High: more than 140/90 mm Hg
     
  • If your are over 65, blood pressure up to 150/90 mm Hg can be considered normal.

If you have a confirmed blood pressure that is higher than this, you have high blood pressure, often called ‘Hypertension’. A singly high reading is not enough to make the diagnosis – you need to have persistently high readings taken at different times on different days.

Does blood pressure stay the same?

No, your blood pressure does not stay the same. For this reason a series of blood pressure readings will need to be taken in order to accurately assess your blood pressure. It varies during the day and night.

Your blood pressure will change in order to meet the demands of your body. It is usually at its highest when we exercise, and lowest when we sleep. It can also rise due to anxiety, excitement, activity or nervousness.

How often should I have my blood pressure checked?

Your blood pressure should be checked at least once a year. If it is too high, you should have re-checked as often as your doctor advises. You may need to start medications if your pressure remains high. Your doctor may also ask you to check your blood pressure at home on a regular basis.

What is so bad about high blood pressure?

If blood pressure is left uncontrolled and remains high, it can damage the vessels that supply oxygenated blood to your internal organs. The very small vessels are often the first to be affected. This can go on to cause kidney disease, heart attack, stroke and loss of vision if left untreated.

How will I know that my blood pressure is high?

You will probably have no symptoms of high blood pressure. Although some people with high blood pressure experience symptoms like headaches, dizziness or nosebleed etc. High blood pressure does not usually give warning signs. Often high blood pressure is detected accidentally or when it produces complications like sudden stroke, heart attack, loss of vision etc. The only way to know if your blood pressure is high is to have it checked regularly. You may have high blood pressure and feel perfectly well.

How are high blood pressure and kidney disease related?

Some kidney diseases may cause high blood pressure, but more commonly, high blood pressure may cause kidney disease. It is often a bit like the “chicken and egg syndrome”. It can sometimes be difficult to tell which came first.

The kidneys produce a hormone called rennin; this helps to control blood pressure in the body. If the kidneys are not functioning properly, rennin release can be increased, raising the blood pressure.

The working units of the kidneys (called nephrons) or kidney filters are damaged after years of stress from the high pressure. Chronic kidney disease caused by high blood pressure is a leading cause of kidney failure, which requires dialysis or a kidney transplant to maintain life. If high blood pressure is controlled, however, your chances of developing chronic kidney disease and other complications can be reduced.

What are the other potential causes of high blood pressure?

The cause of high blood pressure can vary. In 90% of cases, no underlying pathological cause is identified. It may be due to narrowing of the arteries, greater volume of blood or the heart beating faster or more forcefully than it should. This form of high blood pressure is called ‘primary’ or ‘essential’ hypertension. Sometimes high blood pressure is due to a disease or illness. When this is the cause, it is referred to as ‘secondary hypertension’. Treating the disease causing the high blood pressure can help to reduce it. The commonest cause of “secondary hypertension” is chronic kidney disease, like chronic Glomerulanephritis, chronic pyelonephritis, diabetic nephropathy, stone disease etc.

Some people are at greater risk of developing hypertension than others. These include older people, people with a family history of hypertension, and people who are overweight. Smoking, high cholesterol, high fat and salt intake, high alcohol intake, and too little exercise can contribute to high blood pressure or make its effects more serious.

High blood pressure can occasionally be caused by an abnormality in an endocrine gland, such as the adrenal gland. These cases are relatively rare and can be cured by treatment of the gland abnormality. Certain drugs, such as birth control pills, decongestants and diet pills can also raise blood pressure. Your doctor can provide advice on these issues.

If I have high blood pressure, what should I do?

If high blood pressure is detected, your doctor may suggest lifestyle changes such as:

  • Losing excess weight
     
  • Limiting your alcohol intake
     
  • Reducing your fat and salt intake
     
  • Exercising regularly
     
  • Not smoking
     
  • Regular practice of relaxation by yoga and meditation
     
  • Diverting your mind with entertainment by watching dramas, pictures, music etc.

If changes to your lifestyle do not reduce your blood pressure, or if your blood pressure is high, your doctor will prescribe medications. These medications will lower your blood pressure and in most cases, will need to be taken for the rest of your life. It is important to take any blood pressure medications exactly as prescribed. It can be dangerous to stop or change unless your doctor tells you to. If you experience any side effects while taking blood pressure medication, report these to your doctor immediately.

How can people with high blood pressure help themselves?

  • Understand your medication regimen
     
  • Take your blood pressure medications as prescribed
     
  • Do not stop taken your medications of your own accord – this can be dangerous
     
  • Follow your doctor’s recommendations with regard to possible lifestyle changes
     
  • Ask your doctor if it is suitable for you to take your own blood pressure readings

You and your doctor will need to work together to keep your blood pressure under control. It is important to remember that blood pressure can be controlled and successfully treated. Early detection and long-term treatment are the keys to a longer healthier life by preventing kidney failure.

Regular exercise and good diet low in salt and fats will help.

For more information please consult your family doctor or be in touch with your National Kidney Foundation (India).

Urinary Tract Infections & kidneys

Urinary tract infections are common, particularly with increasing age, though they are also common in infants. They are more likely to occur in women than in men. It is seen that considerable number of Indians develops a urine infection each year. Percentage of such women and men who develop a urine infection in their lifetime indicate that in terms of ratio of percentage women are more in number than men.

Urine is normally sterile, that is, it does not contain any germs. Urine infections occur when bacterial organisms (germs) enter the urinary tract. Infection can be limited to the urethra (urethritis), but it may extend to the bladder (cystitis) or even up to the kidney (pyelonephritis).

Cystitis is the most common urine infection. Cystitis causes the bladder lining to become raw and inflamed. Generally cystitis is a nuisance and not a serious condition.

Who is most at risk?

The people most affected by urine infections are women in their late teens or older, often after the onset of sexual activity. Babies are also at risk of urine infection. Pregnancy is another time of risk. Men get urine infections later in life. Urine infections are quite common in elderly people, particularly if they are unwell, in a nursing home or hospital. Bladder catheters and some urinary tract operations may also increase the risk of a person developing urine infections.

What are the symptoms?

Urine infections can cause:

  • Pain and burning on passing urine
     
  • The urge to pass urine frequently
     
  • Blood in the urine
     
  • Pain in the back
     
  • Fever (in babies, fever is often the only symptom)

What is the cause of urine infections?

Bacteria cause urine infections from the bowel. They live on the skin around the urethra and sometimes spread up the urethra to the bladder. The urethra is short in women and sexual intercourse can push bacteria up the urethra since it is situated just in front of the vagina. Urine infections are not contagious and cannot be passed on through sex.

Are urinary tract infections serious?

If infection reaches the kidneys it can become serious. They symptoms may then include chills, fever and loin pain in addition to the other symptoms of a urine infection.

A urine infection in a child needs to be investigated, as it may indicate a more serious condition. An ultrasound of the kidney is usually performed.

In children with urine infection the most common abnormality found is vesico ureteric reflux, a defective bladder valve that allows urine and bacteria to flow back up to the kidneys.

Infections in association with reflux can scar the kidneys and lead to high blood pressure and sometimes kidney failure. Since it occurs in families it is important to screen children as early as possible, if a parent or sibling is known to have influx.

Avoiding urinary tract infections.

Women can reduce their chance of have a urine infection by:

  • Drinking lots of fluid (especially water) to wash bacteria from the bladder and urinary tract
     
  • Wiping from front to back after going to the toilet to help reduce the amount of bacteria near the urethra
     
  • Emptying the bladder after sexual intercourse

Men should see their doctor if they any trouble with the urine stream and difficulty starting and stopping urine flow as this may indicate an enlargement of the prostate.

For more information please consult your family doctor or be in touch with your National Kidney Foundation (India).


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