Hypertension is a public health epidemic and is one of the most common reasons for prescription drug therapy. In the U.S. it is a major risk factor for death and disability. It is, however, the most important modifiable risk factor for premature heart disease. Risk factors for hypertension include age, obesity, high salt diet, excessive alcohol consumption, physical inactivity, and chronic kidney disease.
Chronic elevation of BP can lead to multiple organ injury including the eyes, heart, blood vessels, brain, and kidneys.
How are the kidneys and blood pressure related?
Blood pressure is regulated in our body by several mechanisms, but the sympathetic nervous system and hormonal regulation play key roles. Renin, a hormone produced in our kidney, regulates the absorption and elimination of salt in urine (which in turn affects BP).
If our kidney function declines, the ability to regulate BP also goes down which can lead to Hypertension. Interestingly, hypertension can be both the cause and effect of kidney disease.
Blood Pressure Measurement
It is very important to use the proper technique when checking blood pressure. Not only that but the BP must be checked multiple times before making a diagnosis.
- Avoid smoking, caffeinated beverages or exercise within 30 minutes of checking
- Be seated quietly in a chair for more than 5 mins with your back supported, feet on the floor, legs uncrossed, arm supported and upper arm at the level of the heart
- Use a properly calibrated instrument
- The cuff size should be chosen to ensure that it encircles 80% of the upper arm
‘Ambulatory BP monitoring’ can also be used in patient with masked or white coat hypertension. An ambulatory device is worn for 24 hours or longer and measures BP every 15 to 60 minutes during the day and sleep. We then take an average of the daytime and nighttime measurements. Normal BP by this method is < 115/75.
Checking BP at home can be used to assess the response to changes one has made in their lifestyle (diet and exercise). Talk to your health care provider if you have or think you have Hypertension.