Hypertension or high blood pressure is a chronic medical condition in which the blood pressure in the arteries is elevated. Hypertension can result from too much fluid in normal blood vessels or from normal fluid in narrow, stiff, or clogged blood vessels. Blood pressure measures the force of blood against the walls of the blood vessels. Extra fluid in the body increases the amount of fluid in blood vessels and makes blood pressure higher. Narrow, stiff, or clogged blood vessels also raise blood pressure. Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic kidney failure.

It is surprising to know that Hypertension is the second major cause, after diabetes, of end stage renal diseases or kidney failure and is responsible for 25-30% of all reported cases.

When you should check for Hypertension?
Most people with primary hypertension don't have any obvious symptoms at all; also the possible symptoms of hypertension vary quite a lot from person to person. Common symptoms of hypertension are:

Chronic headaches, Dizziness or Vertigo, Blurry or double vision, drowsiness, nausea, Shortness of breath. Usually when this occurs people start to get a little concerned. This is a high time when one should check a doctor as by this time the blood pressure levels reaches an alarming stage. If untreated the conditions progress and in extreme cases a person experience, heart palpitations, fatigue - general tiredness, a flushed face, Nosebleeds, a strong need to urinate often (especially during the night),Tinnitus (a ringing or buzzing in the ears)

What are the common causes of hypertension?

• Smoking
• Obesity or being overweight
• Diabetes
• Sedentary lifestyle
• Lack of physical activity
• High levels of salt intake (sodium sensitivity)
• Insufficient calcium, potassium, and magnesium consumption
• Vitamin D deficiency
• High levels of alcohol consumption
• Stress
• Aging
• Medicines such as birth control pills
• Genetics and a family history of hypertension
• Chronic kidney disease
• Adrenal and thyroid problems or tumors How Hypertension is diagnosed?
• Regular blood pressure checking: Blood pressure is measured with a blood pressure cuff and recorded as two numbers, for example, 120/80 mm Hg (millimeters of mercury).
• The upper measurement is called the systolic pressure and the lower one is called the diastolic pressure.
• Normal blood pressure is: < 120/80
• Pre-hypertension range is: 120-139/80-89
• High blood pressure (stage 1): 140-159/90-99
• High blood pressure (stage 2): > 160/100
• Patient history to collect including symptoms like chest pain
• Family history of high blood pressure
• Medical history of co-morbid conditions like diabetes
• Physical examination
• Blood tests (as indicated)
• Electrocardiogram
• Echocardiogram or ultrasound of the heart

How to treat Hypertension?

All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications, such as eating a healthier diet, including the DASH diet (eating more fruits, vegetables, and low fat dairy products, less saturated and total fat). Reducing the amount of sodium in the diet to 2,300 milligrams (about 1 teaspoon of salt) a day or less. Quitting smoking, and getting more exercise. Taking the requisite medicines like Diuretics, Beta-blockers to name a few.

What are the Preventive Care for hypertension?

• Maintaining a proper weight
• Reducing salt intake
• Increasing physical activity - According to some studies, men who lead physically active lives can reduce their risk of developing hypertension by 35 - 70 %. Regular exercise also helps keep your weight in check. Aim for at least 30 minutes of moderate exercise -- such as walking - every day.
• Limiting alcohol consumption - If you drink alcohol, limit your intake to one drink per day if you are a woman and two if you are a man.
• Eating a diet rich in fruits and vegetables.

Hypertension: What it means to kidney?
Hypertension (High blood pressure) makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. As a result, dangerous levels of fluid and waste can accumulate. You might ultimately require dialysis or kidney transplantation.


What are the types of kidney failure?
Kidney Failure is of two types:

1. Acute Kidney failure which is caused due to sudden impairment of renal function marked by low blood volume, exposure to toxins, prostrate enlargement, insult and injury kidney.
2. Chronic kidney disease occurs when one suffers from gradual and usually permanent loss of kidney function over time. This happens gradually from months to years.

What are the Signs and Symptoms of Chronic Kidney Disease?
The signs and symptoms of kidney failure include a decrease in urine output, fluid retention, swelling, drowsiness, shortness of breath, fatigue, and in severe cases, chest pain, seizure, or coma. Fluid retention is the most noticeable sign of kidney failure, and swelling of the feet, ankles, or legs as a result of the fluid build-up is generally obvious.

How to diagnose Kidney Failure?
Blood test will show whether the kidneys are removing waste efficiently .The doctor should order tests to measure serum creatinine .Having too much creatinine in your blood is a sign that you have kidney damage. Another sign is the proteinuria or protein in your urine.

What are the treatment options for Kidney Failure?
Once physicians diagnose end stage renal disease, they must make a plan for dialysis. There are two types of dialysis;

Hemodialysis: A procedure that uses a machine and a dialyser to clean and filter the blood, since the kidneys can no longer perform that function. A connection from the machine is made to the patient's bloodstream and the blood travels through the dialyser where it is cleaned for 2–4 hours. This procedure is generally performed three times a week.

Peritoneal dialysis: Another option for patients with kidney failure. In this procedure, the patient's own abdominal lining (the peritoneal membrane) is used to help clean the blood. In this process, a fluid is transferred through a special tube (catheter) directly into the abdominal region. The catheter remains in the body. The numbers of treatments and time to perform the cleansing procedures vary.

The patient in consultation with a doctor has to choose which dialysis treatment is best suited for him. Moreover, it is possible to switch from one type of dialysis to the other if preferences or conditions change over time.

Earlier there was a misconception that eventually a patient suffering from kidney failure has to undergo kidney transplant. But now a days, with ‘Quality Dialysis’ people can be on HD or PD throughout his life span. But the long waiting time for a perfect donor, chances of organ rejection are some of the reasons which make dialysis treatment an inevitable option. Hence it is very important to choose the right kind of dialysis equipments and treatment which ensures a good quality both during and after the dialysis and also reducing the risk of side effects.

Dhruv Chaturvedi: The author is the General Manager of Fresenius Medical Care in India, the global leaders of Quality dialysis services and products. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it. .