High blood pressure (also called hypertension) is the second leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the U.S. Patients with ESRD must start dialysis or get a kidney transplant to continue living. According to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), high blood pressure causes more than 25,000 new cases of ESRD in the US every year.1
Blood travels away from the heart through special blood vessels, called arteries, to all parts of the body. The pressure of the blood against the walls of the arteries as the heart pumps is what is measured. The blood pressure measurement has two numbers: a top one, and a bottom one. The top number (systolic) is the pressure when the heart pumps blood out. The bottom number (diastolic) is the pressure when the heart relaxes before the next beat.
When blood pressure is high and left untreated, it can damage the blood vessels that carry blood throughout the body. The smaller blood vessels are the ones usually affected first. Kidneys have small blood vessels that can become damaged by high blood pressure. This can lead to CKD. Because one of the jobs of the kidneys is to control blood pressure, this can cause more problems.
Most people with high blood pressure do not know they have it because they don’t have any symptoms. Unfortunately, a heart attack or stroke can sometimes be the first sign of a problem. The only way to know if your blood pressure is high is to have it checked by a health care provider.
A blood pressure reading lower than 120/80 is desirable. Lower readings are usually found in children and adults who are in excellent physical condition. A person’s blood pressure is considered high if the top number is higher than 140 and the bottom number is higher than 90 (though these numbers could change). See below for healthy and unhealthy blood pressure ranges, as recommended by the American Heart Association.
| Blood Pressure Category | Systolic mm Hg (upper number) | Diastolic mm Hg (lower number) | |
|---|---|---|---|
| Normal | Less than 120 | And | Less than 80 |
| Elevated | 120 – 129 | And | Less than 80 |
| High Blood Pressure (Hypertension) Stage 1 | 130 – 139 | Or | 80 – 89 |
| High Blood Pressure (Hypertension) Stage 2 | 140 or higher | Or | 90 or higher |
| Hypertensive Crisis (Consult Your Doctor Immediately) | Higher than 180 | And/or | Higher than 120 |
Usually, blood pressure is lowest when sleeping and highest when exercising. Because blood pressure varies throughout the day, several readings should be taken to get a true measurement. One high reading alone may not mean a person has high blood pressure. That’s why it takes a few readings to determine if a person has high blood pressure.
As people get older, they tend to get high blood pressure. The National Heart, Lung, and Blood Institute (NHLBI) reports that over 50 percent of Americans age 60 and older have high blood pressure. The NHLBI also indicates that chances of getting high blood pressure are even greater for:
People of certain ethnic backgrounds are also more likely to get high blood pressure. African Americans, Asian Americans, Native Americans, and Hispanic Americans are more likely than Caucasian Americans to have high blood pressure and to develop chronic kidney disease because of it.
Remember, you have some control over your blood pressure. By maintaining a healthy weight, not smoking, exercising regularly, limiting salt intake, not drinking too much alcohol, and taking prescribed medicines as directed by your physician, you are taking steps in the right direction.
You can also buy a home blood pressure monitor and keep track of your blood pressure as often as you wish. Ask your health care provider to show you how to take your blood pressure. In some cases, your insurance may cover a blood pressure cuff. Otherwise, you can find affordable blood pressure monitors in most drug stores.
Make sure you visit your doctor regularly for routine checkups, which should include a blood pressure check. By controlling the things you can and following your doctor’s advice, you help to keep your blood pressure within normal limits.
