Loosened Blood Pressure "Cuffs:" BP Guidelines Dangerously Wrong For Chronic Kidney Disease Patients

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High blood pressure is a serious condition in Chronic Kidney Disease (CKD) patients that can cause strokes, heart attacks and death. In fact, Cardiovascular issues, which can be exacerbated due to high blood pressure, are the leading cause of death in those with CKD. Hence, many CKD patients can likely understand the shock when new Hypertension (high blood pressure) Management Guidelines released by the Journal of the American Medical Association suggested that people with CKD can handle higher blood pressure levels than outlined in current guidelines. Based on a Thursday December 19th, 2013 report out of Medpage Today, the American College of Cardiology (ACC) and the American Heart Association (AHA) recommended allowing systolic blood pressure (top number) to reach a minimum of 140 or the diastolic blood pressure (bottom number) to be at least 90 before administering any medicinal treatment for CKD patients. 

Recommended Reading: CKD Patients Should Track Their Blood Pressure Numbers 

This is a huge jump from previous guidelines which set CKD target blood pressure at less than 130/80 mm Hg. According to Dr. Eric Peterson, Duke University, these higher blood pressure cutoffs could have a very mixed effect, "On the individual patient level, that makes our job easier .... We don't have to push blood pressures quite as far down," he told MedPage Today. "On the other hand, from a population level, I have some concerns that this less aggressive push will ultimately translate into higher blood pressures on America's front and perhaps in the end, more cardiovascular events." 

Recommended Reading: Newly Recommended Changes To "Normal" Blood Pressure For CKD Patients To Avoid Risk of Mortality 

Guidelines have grown in importance, becoming the basis for quality measures and coverage decisions. Hence, pushback from these new recommendations is expected from Nephrologists and patients alike. The panel of decision makers, however, believes that they are on "solid ground in its interpretation of high-quality evidence about the limited but important set of questions that it chose to address." 

Recommended Reading: New Changes To Guidelines For Anemia Will Impact EPO Treatment In Chronic Kidney Disease Patients 

The lead researchers found that it was critically important for those with CKD to implement lifestyle interventions, and maintain them to manage their blood pressure before moving on to drug therapy. They wrote,  "For all persons with hypertension, the potential benefits of a healthy diet, weight control, and regular exercise cannot be overemphasized. These lifestyle treatments have the potential to improve blood pressure control and even reduce medication needs." 

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Recommended Reading: Many with CKD die from Cardiovascular Disease instead of Kidney Disease 

The long list of side effects from high blood pressure medication include heart disease, memory loss, muscle pain, neuropathy, arthritis, and depression. If these side effects can be avoided they should be. Still it is not at all advisable for you to medicate yourself by just stopping your current medicinal regimen. KidneyBuzz.com encourages all of its readers to discuss, with their Nephrologists, these new guidelines and what exactly they mean for them personally. 

Note: Do not forget to order your No BP/No Stick Medical Alert Bracelet  and your FREE KidneyBuzz.com Impact Meal Recipe Book!  

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References: 

Neale, Todd. "Expert Panel Want BP Cuffs Loosened." Http://www.medpagetoday.com/. MedPage Today, LLC.

Willingham, Val. "High Blood Pressure? Well, Maybe Not." Http://www.kionrightnow.com/. NPG of California, LLC.