Treating High Blood Pressure When You Have Kidney Disease

High blood pressure, or hypertension, is one of the leading causes of kidney disease. Many people with high blood pressure need medicine to help lower blood pressure, which also helps to slow the progression of kidney disease. Two groups of medicines that lower blood pressure are:

Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin II is a chemical in the body that narrows blood vessels by making the muscles around the blood vessels contract. It creates a chemical called angiotensin I. ACE inhibitors prevent angiotensin I from creating angiotensin II. This helps the muscles around the blood vessels relax and enlarges the blood vessels, which reduces blood pressure.
Angiotensin receptor blockers (ARBs)
ARBs block angiotensin II from causing the muscles around the blood vessels to contract and make the blood vessels smaller. ARBs protect the blood vessels from the effects of angiotensin II so that blood pressure stays in a safe range.

ACE inhibitors and ARBs lower blood pressure, which also helps to slow kidney damage. Some people may need to take a combination of two or more blood pressure medicines to stay below 130/80.

What medicines treat high blood pressure?

ACE inhibitors and ARBs are the two main groups of medicines used to treat high blood pressure. However, sometimes other medicines are needed in combination with ACE inhibitors and ARBs to get blood pressure down to a healthy level. The following list shows the major types of commonly used drugs for treating high blood pressure.

Type of drug	What it does
Diuretics	Rid the body of excess water, helping to lower blood pressure.
Potassium-sparing diuretics	Prevent potassium loss in the body. They can be prescribed alone or used with another diuretic.
Beta-blockers	Reduce the heart rate and the heart’s output of blood. Note: asthmatics and people with poor circulation cannot use beta-blockers. Some beta-blockers cause insomnia, fatigue, depression and cold hands and feet.
AIIR antagonists	Can be used if ACE inhibitors cause side effects. Requires blood tests to monitor side effects.
Alpha-blockers	Useful as a second or third drug to further reduce blood pressure.
Calcium channel blockers	Added to other therapy to further reduce blood pressure. Some may cause a rapid heartbeat, swollen ankles, constipation, headache or dizziness.
Centrally acting drugs	May cause side effects, but is safe during pregnancy.

How else can I control my blood pressure?

In addition to taking medicine that's prescribed by your physician, the following lifestyle changes may help control blood pressure:

Maintain your weight at a level close to normal. Eat fruits, vegetables, grains and low-fat dairy foods.
Limit your daily sodium intake. For example, avoid fast food, which is high in salt.
Exercise for at least 30 minutes a day.
Avoid drinking too much alcohol. For men, two drinks (two 12-ounce servings of beer or two 5-ounce servings of wine or two 1.5-ounce servings of "hard" liquor) a day. For women, one alcoholic beverage per day.
Limit caffeine intake.
Stop smoking. Smoking raises blood pressure.

If you think a loved one should know their risk for kidney disease because of high blood pressure, encourage them to take the Risk Quiz today.