High Blood Pressure and Kidneys: Treatment Options

If you have kidney damage, you should keep your blood pressure below 130/80. It is recommended that people with kidney disease use whatever high blood pressure treatment is necessary -- including lifestyle changes and blood pressure medicine -- to keep their blood pressure below 130/80.

 

Many people need blood pressure medicine to control high blood pressure. Two groups of blood pressure medications called ACE inhibitors (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) lower blood pressure and have an added protective effect on the kidneys in people with diabetes. Additional studies have shown that ACE inhibitors and ARBs also reduce proteinuria and slow the progression of kidney damage in people who do not have diabetes.  An example of an effective ACE inhibitor is captopril (Capoten^®).  Effective ARBs include losartan (Cozaar^®) and irbesartan (Avapro^®).

 

You may need to take a combination of two or more blood pressure medicines to stay below 130/80. Your doctor may also prescribe a diuretic in addition to your ACE inhibitor or ARB. Diuretics are also called "water pills" because they help you urinate and get rid of excess fluid in your body.

 

For African Americans, an ACE inhibitor was better at slowing the progression of kidney disease than diuretics or ARBs.