Services & Specialties

Treatments for High Blood Pressure


It is essential to control high blood pressure to avoid serious health problems. Of the more than 65 million Americans affected, only 50% consistently have their blood pressure within the range targeted by treatment.

Even if there are no symptoms, high blood pressure can cause significant cardiovascular and organ damage. Patients who have kidney disease are especially at risk for permanent damage caused by high blood pressure. If you have high blood pressure, delaying treatment will cause more problems.

Successful treatment for hypertension may include:

  • Routine follow-up appointments
  • Medications, including anti-hypertensive drugs, diuretics, and your ability to know what you are taking
  • Dietary restrictions, including a low-sodium diet
  • Exercise
  • At-home monitoring of your own blood pressure


Resistant Hypertension

Resistant hypertension is the failure to control blood pressure to achieve below 140/90 consistently, despite adequate therapy of at least two blood pressure medications plus a diuretic. Florida Kidney Physicians specializes in this problem. The patient’s regimen will depend on other co-existing medical conditions or risk factors.

The top four causes of resistant hypertension are:

  1. Less-than-optimal therapy or inadequate care
  2. Intolerance to medication
  3. Secondary causes such as other medical complications
  4. Patient noncompliance (not taking medications, not exercising sufficiently, not following a low salt diet, or abusing alcohol or other drugs)


High Blood Pressure by Cultural, Sex, and Age Factors


  • African Americans
  • Women
  • Seniors
  • Young Adults
African Americans

African Americans are affected at a higher rate (1 in 3) than whites (1 in 4), and are more likely to suffer from severe hypertension. In addition, African Americans are at a greater risk for diabetes and have as many as 4-5 times the incidence of hypertensive kidney disease, increasing the risk of heart disease and death. For this reason, it is a priority to treat high blood pressure very aggressively to goal levels of less than 135/85.

According to current recommendations from the International Society on Hypertension in Blacks, patients should use a combination of medication with a diuretic, plus an ACE inhibitor or beta blocker, to effectively treat high blood pressure. Sodium restriction is an integral part of therapy, as well as following the DASH diet. For more information, visit our Patient Resources page.

Women

Prior to menopause, at an average age of 50, women have a lower probability of high blood pressure than men. However, women older than 50 have a higher rate of high blood pressure compared to men in the same age group, and by age 70 almost 80-90% of women have high blood pressure. Proven lifestyle changes that help women lower their risk of hypertension are:

  1. Keep body mass index (BMI) below 25
  2. Regularly getting 30 minutes of exercise each day (minimum of 3 days/week)
  3. Following the DASH diet
  4. Moderate alcohol consumption (less than 2 drinks per day)
  5. Infrequent use of pain medications (like ibuprofen or other NSAIDS)
  6. Folate intake of at least 400 mcg per day (found in spinach, collard greens, beans, etc.)

Seniors

Seniors* are defined as people over 65 years old. As many as 60-80% of Americans over this age have hypertension, and most exhibit classic hypertension where the top number is high and bottom number is low (called isolated systolic hypertension or ISH).

These patients’ blood pressure should be measured while standing, since orthostatic hypotension (sudden drop in blood pressure when a person stands up) is common in this age group.

Blood pressure control needs to be gradual in this population. Treatment should include a low sodium diet. Factors that may limit treatment include dizziness, confusion, and sleepiness at lower blood pressures. In these patients, therapy is tailored to allow standing blood pressure to rise to a level where the patient’s symptoms improve.

*Florida Kidney Physicians disagrees with grouping patients by age, as other factors including functionality and/or the existence of other illnesses are more relevant to treatment.

Young Adults

It is unusual for patients to have hypertension before age 30. These young patients need special evaluation for secondary causes of hypertension. Possible causes of secondary hypertension include:

  • Obesity
  • Congenital kidney disease (reflux nephropathy, neurogenic bladder, cystic disease)
  • Hereditary hypertension (polycystic kidney disease, mineralocorticoid excess, familial hyperaldosteronism, Liddle syndrome, or Gordon syndrome)
  • Congenital adrenal hyperplasia
  • Acquired nephritis, lupus, IgA nephropathy, minimal change disease (inflammation of the kidney)
  • Coarctation of the aorta
  • Fibromuscular dysplasia
  • Birth control medications
  • Use of drugs (cocaine, amphetamines, diet pills)
  • Polycystic ovarian syndrome (PCOS)
  • Empty sella syndrome


Controlling high blood pressure is critical in avoiding kidney disease. That’s why it’s important to get regular checkups by a qualified nephrologist.

Florida Kidney Physicians has more than 36 providers with 13 locations across the Tampa Bay area and Southeast Florida. For an appointment, call us during business hours or use our online appointment request form at your convenience.

Copyright by Florida Kidney Physicians.