Recently, I met a friend with high blood pressure who complained to Dr. Zhang, “I have been taking antihypertensive drugs for 10 years, my high blood pressure hasn’t been cured, but my kidneys are damaged.” Is it really because of taking antihypertensive drugs that his kidneys were damaged? Today, let’s discuss this issue.
The prevalence of high blood pressure among adults in our country is very high, and many friends are troubled by high blood pressure. The frightening aspect of high blood pressure is that if not controlled well, it can lead to serious complications such as heart disease, stroke, and kidney damage over time. Many friends are using antihypertensive drugs to control blood pressure.
However, some friends may think that taking antihypertensive drugs can damage kidney function. Indeed, some friends have experienced symptoms of kidney damage during the course of taking antihypertensive drugs. Is it kidney damage caused by hypertension or by antihypertensive drugs? Generally, it occurs in three situations.
Not taking medication according to prescribed dosage:
Many friends mistakenly believe that the more types of antihypertensive drugs they take, the greater the damage to liver and kidney function. Therefore, they insist on taking a single antihypertensive drug and when blood pressure is not well controlled, they keep increasing the dosage of the antihypertensive drug. Little do they know that this usage is completely incorrect.
Each antihypertensive drug has a limited recommended dosage. Exceeding the normal dosage has very limited benefits in terms of improving efficacy but can easily lead to drug toxicity. Since most antihypertensive drugs are metabolized by the liver or kidneys, excessive intake can easily lead to kidney damage.
When one antihypertensive drug alone cannot completely control blood pressure, it is recommended to use combination therapy. Compared to high doses of a single drug, combination therapy has the following advantages:
Different mechanisms of action have a synergistic effect on blood pressure reduction, resulting in a magical effect of 1+1>2 in lowering blood pressure.
Reduce side effects: The toxic side effects of drugs are closely related to the dosage. When taking two or more antihypertensive drugs, the dosage of each drug is relatively small, reducing the likelihood of side effects.
Classic combinations can counteract the side effects of drugs.
For hypertension of grade 2 or above, doctors often recommend the direct use of two or more antihypertensive drugs for the above reasons. Therefore, when a single antihypertensive drug is ineffective in controlling blood pressure, it is necessary to promptly adjust the treatment at the hospital. Do not rely on simply increasing the dosage to control blood pressure, as it can easily lead to liver and kidney damage, resulting in serious consequences.
Incorrect drug usage leads to poor blood pressure control:
Many friends, in the process of taking medication, choose incorrect medication methods due to concerns about the side effects of drugs. Common mistakes include:
Taking medication when blood pressure is high and not taking it when blood pressure is not high;
Arbitrarily reducing drug dosage;
Only taking medication without monitoring blood pressure.
These incorrect behaviors can lead to failure to meet blood pressure control standards or unstable blood pressure control, which can cause glomerulosclerosis of kidney glomeruli, compromising kidney function. Glomeruli are the basic units of kidney function, and when the number of damaged glomeruli exceeds the compensatory capacity of the kidneys, a series of symptoms will appear. At this point, it is too late to try to save the situation.
Therefore, the treatment of hypertension must involve proper medication under the guidance of a doctor, avoiding arbitrary adjustments to medication methods and dosages. Regular monitoring of blood pressure is necessary, and if blood pressure abnormalities occur, prompt adjustments should be made at the hospital.
Relying solely on antihypertensive drugs for blood pressure control without moderation in lifestyle:
The treatment of hypertension involves both medication and lifestyle adjustments, both of which are equally important and cannot replace each other. For some friends, lifestyle adjustments may be even more crucial. If hypertension treatment solely relies on medication without moderation in lifestyle, blood pressure will not be well controlled. In the long run, it can lead to kidney damage and eventually kidney failure.
In daily life, friends with hypertension need to take measures such as: low-salt, low-fat, low-calorie diet; weight control; regular exercise; quitting smoking and alcohol; avoiding exhaustion, stress, and staying up late. Only by adopting a healthy and reasonable lifestyle can blood pressure be effectively controlled. Some friends with grade 1 hypertension, if without complications, have the opportunity to lower blood pressure to normal through lifestyle management alone, without the need for lifelong antihypertensive medication.
After careful inquiry by Dr. Zhang, the friend mentioned at the beginning did not receive standardized treatment for hypertension, which led to unstable blood pressure control and ultimately kidney failure.
In summary, unless antihypertensive drugs are taken in excess, most kidney function damage is due to poor blood pressure control, not the antihypertensive drugs themselves. For friends with hypertension, to avoid kidney damage, they must adhere to regular medication under the guidance of a doctor, undergo timely follow-up tests, monitor blood pressure, and strictly control unhealthy dietary and lifestyle habits. This ensures good treatment outcomes and effectively prevents the occurrence of complications.
Regarding the question of whether antihypertensive drugs can lead to kidney failure, we will end the discussion here today. If you agree with Dr. Zhang’s views, feel free to like, comment, or follow. It’s not easy to create, so thank you for your support. If you have other questions or opinions, please leave them in the comments section. Good questions are also an important source of inspiration for me. Looking forward to your help. I am Dr. Zhang Wei, a specialist in nephrology. See you next time.
References:
[1] WHELTON P K, CAREY R M, ARONOW W S, et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults:Executive Summary: A Report of the American College ofCardiology/American Heart Association Task Force on ClinicalPractice Guidelines[J]. Hypertension, 2018, 71(6):1269-1324.
[2] WILLIAMS B, MANCIA G, SPIERING W, et al. 2018 ESC/
