Blood Pressure Best Managed When Healthy Lifestyle is Central to Treatment, Experts Say
Washington, DC (May 11, 2012) - New approaches to controlling blood pressure are on the horizon, according to a presentation at the 2012 National Kidney Foundation Spring Clinical Meeting - but ultimately, the most powerful step patients can take is to improve their lifestyle, particularly reducing salt intake.
"It's an exciting time in blood pressure management," says George Bakris, MD, member of the National Kidney Foundation board of directors and a professor of medicine and director of the ASH Comprehensive Hypertension Center at The University of Chicago Medicine. "We have some really promising new techniques to lower blood pressure in kidney disease that are being investigated as we speak."
However, during a session co-chaired by Dr. Bakris, experts reaffirm that the most effective way to lower blood pressure in chronic kidney disease (CKD) is to stop smoking, start exercising, and make other healthy changes. In particular, Dr. Bakris says doctors need to do a better job of educating patients about the importance of reducing salt intake - without that, any other measure won't make much of a difference. "Doctors can prescribe as much medication as they like, but if patients continue to eat a high salt diet, their blood pressure will never be fully controlled," he says.
During the session, Dr. Bakris and his colleagues described a new technique to control blood pressure known as renal denervation. It's already approved in Europe and Australia, but won't be in the U.S. for at least another 18 months. As part of the technique, doctors deactivate the nerves that send signals to the kidney, heart, and brain in response to changes in blood pressure. Although not all patients experience decreases in blood pressure immediately following surgery, within three years, most see improvements, explains Dr. Bakris. "We don't know exactly why it works, but it does."
Another new implantable device stimulates little neural bundles in the neck that help regulate blood pressure. This device is likely further away from general usage, but also holds exciting promise, said Dr. Bakris.
"The overall evidence suggests that both new approaches can safely reduce blood pressure in patients with resistant hypertension," says Dr. Bakris. "Both work, but by different mechanisms, in different parts of the body."
Controlling blood pressure is a major issue for people with CKD, adds Dr. Bakris, most of whom exceed recommended targets, putting them at higher risk of kidney failure. "The important thing is to get a patient's blood pressure under control - not how you do it," he notes. "Whether you start with one class of medication versus another class doesn't matter. In this case, the ends justify the means."
The National Kidney Foundation is dedicated to preventing and treating kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases and increasing availability of all organs for transplantation.
For more information about high blood pressure and the kidneys, contact the National Kidney Foundation at www.kidney.org.