High Blood Pressure and Kidney Disease: 9 Things To Know

Medically reviewed by Sarika Chaudhari, M.D., Ph.D.
Written by Maureen McNulty
Posted on December 8, 2023

High blood pressure, also called hypertension, affects about 50 percent of people in the United States (U.S.) — and it’s even more common in those with kidney disease. For this reason, your doctor may want to keep a close eye on your blood pressure if you’re living with kidney issues.

Blood pressure measures how hard your blood is pushing against the walls of your blood vessels. It’s evaluated using two numbers. Your doctor will diagnose you with high blood pressure if the top number (systolic blood pressure) is 130 millimeters of mercury (mm Hg) or higher or if the bottom number (diastolic blood pressure) is at least 80 mm Hg.

How is high blood pressure linked to kidney disease? Read on to learn about nine important things to keep in mind.

1. High Blood Pressure May Damage Your Kidneys

High blood pressure has the potential to cause kidney disease. When you live with unmanaged high blood pressure for an extended period, your blood vessels can lose some of their strength. This can lead to various health problems, including issues with your kidneys.

Your kidneys contain many tiny blood vessels. As blood flows through, your kidney removes waste products and extra water. If you have high blood pressure, these delicate blood vessels are damaged and fail to do their job, causing toxic wastes and fluid to build up in your body. If this continues, there can be scarring of the kidney tissue and permanent damage. This condition can lead to kidney disease, make existing kidney issues worse, or even trigger kidney failure.

2. Kidney Disease Can Lead to High Blood Pressure

Elevated blood pressure can cause kidney problems, but the reverse is also true — kidney disease can raise your blood pressure levels.

Your kidneys partially control your blood pressure. Kidneys filter your blood and take out waste and extra fluid in the form of urine. When these organs aren’t working correctly, the fluid starts to build up inside the blood vessels, and your blood pressure levels may not stay within a healthy range. The extra fluid in the blood vessels makes the blood pressure go up. Any kidney disease that damages the kidney tissue including the blood vessels can cause high blood pressure. For example, immunoglobulin A (IgA) nephropathy is a condition in which too many antibody proteins build up in the kidneys, leading to kidney damage that raises your blood pressure.

3. Certain Factors Can Increase Your Risk of High Blood Pressure

In addition to chronic kidney disease, other conditions or personal characteristics may lead to a greater chance of having high blood pressure. These include:

  • Being of an older age
  • Having a family history of high blood pressure
  • Eating a lot of salt, sugar, saturated fats, or trans fats
  • Consuming excessive alcohol
  • Smoking cigarettes or using other tobacco products
  • Spending a lot of time sitting or lying down
  • Having high cholesterol levels
  • Feeling very stressed out on a regular basis
  • Being diagnosed with diabetes or sleep apnea

Many of these conditions worsen the hardening of your blood vessels and cause your blood pressure to rise further. If you have any of the above risk factors, keep an eye on your blood pressure levels. Make sure to visit the doctor regularly and have your blood pressure checked.

4. High Blood Pressure Doesn’t Typically Cause Symptoms

Most people don’t experience any warning signs that their blood pressure is getting too high. In fact, about one-third of Americans who have high blood pressure don’t realize it. It is referred to as the “silent killer.”

Severe high blood pressure may cause headaches, nosebleeds, or difficulties taking a deep breath. However, this isn’t common — you generally won’t know you have this condition until your blood pressure levels are checked.

5. High Blood Pressure Can Lead to Other Health Problems

It’s important to address high blood pressure so that you can prevent damage to other organs and tissues. If left uncontrolled, high blood pressure can cause complications (additional health problems). In addition to causing kidney damage, it may increase your risk of a heart attack, stroke, diabetes, eye damage, or dementia. Working with your doctor to implement a high blood pressure treatment plan may help prevent these issues.

6. Treatments for High Blood Pressure Can Also Help Manage Kidney Disease

Letting your high blood pressure go untreated is not a good idea — when severe, this condition can quickly lead to kidney damage and is one of the main causes of kidney failure. However, treating your high blood pressure through lifestyle changes and medications can help keep your kidney damage from becoming worse and reduce your risk of heart disease and other problems.

7. Regularly Checking Your Blood Pressure Can Help You Treat It

Regular checkups are important for the early detection of high blood pressure. Also, if you’ve been diagnosed with high blood pressure, you can use regular blood pressure checks to determine whether your treatment plan is working to manage your condition.

Your doctor will typically measure your blood pressure during visits with a blood pressure cuff that inflates with air. You can also buy a blood pressure cuff to use at home. If you’re not sure how to use it, ask your health care team for help.

Try to check your blood pressure regularly. This may help you determine when lifestyle changes or treatments are working to lower your blood pressure and when you may need to take extra steps to get your blood pressure to normal levels.

8. Lifestyle Changes May Help

Certain habits and behaviors can help you lower blood pressure levels, which may, in turn, help your kidney health.

The food you eat has a direct impact on your blood pressure. To manage your blood pressure effectively through your diet, consider eating more vegetables, fruits, whole grains, nuts, and fiber-rich, protein-packed fish. Additionally, foods rich in calcium and magnesium can be helpful. You’ll want to limit high-sodium (salt) items, saturated and trans fats, cholesterol, and sugary foods whenever possible.

Your doctor may also recommend a specific diet to help control your blood pressure, such as the Dietary Approaches to Stop Hypertension (DASH) diet. However, if you have kidney disease and hypertension, you will be asked to avoid certain foods, especially those high in sodium, potassium, and phosphorus.

Exercise is also an important part of maintaining healthy blood pressure levels. Doctors recommend getting at least half an hour of physical activity each day. This includes aerobic exercises (activities that increase your heart rate) such as walking, running, swimming, or playing tennis. It also includes resistance training (exercises that increase muscle strength) like weight lifting.

Eating a healthy diet and getting more activity may also help you lose weight, which can further reduce your blood pressure levels. If you’re overweight, for every 2.2 pounds (1 kilogram) you lose, your blood pressure is likely to decrease by 1 mm Hg.

Mayo Clinic recommends these strategies to help bring your blood pressure down to safer levels:

  • Quitting smoking
  • Drinking less alcohol (no more than one drink per day for women and two drinks per day for men)
  • Getting enough sleep (seven to nine hours each night for adults)
  • Reducing stress levels with exercises focused on relaxation, deep breathing, or gratitude

If you hope to prevent or help treat high blood pressure with lifestyle changes, talk to your doctor to get more personalized tips regarding which changes may be most helpful to you.

9. High Blood Pressure Can Also Be Controlled With Medication

In many cases, lifestyle changes aren’t enough to control your blood pressure. Your doctor may prescribe blood pressure medications like:

  • Diuretics (water pills) — Help get rid of extra fluid in your body
  • Calcium channel blockers — Widen your blood vessels or slow your heart rate
  • Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers — Relax your blood vessels
  • Beta-blockers — Help protect your heart health by making it beat more gently
  • Alpha-blockers — Prevent the blood vessels from getting too narrow
  • Vasodilators — Relax your blood vessel walls

It’s important to follow your medication plan. Don’t stop taking your medication without first talking to your doctor — you may need to gradually decrease your dose to prevent further health issues. If you have a hard time remembering to take your medicine or you don’t like the side effects, tell your doctor. Your health care team should be able to find a treatment plan that works well for you.

To learn more, read “Improving Life Expectancy With Kidney Disease: What Matters Most?

Talk With Others Who Understand

On MyKidneyDiseaseCenter, the site for people with kidney disease and their loved ones, people come together to gain a new understanding of different types of kidney disease and share their stories with others who understand life with the condition.

Has your doctor told you that you have high blood pressure? What are you doing to manage it? Share your experience in the comments below.

Posted on December 8, 2023
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Sarika Chaudhari, M.D., Ph.D. completed her medical school and residency training in clinical physiology at Government Medical College, Nagpur, India. Learn more about her here
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here

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