Team L&M
India has been facing a silent but deadly connection between hypertension and kidney diseases. This alarming trend has raised concerns among healthcare professionals, and consumer rights champions’ has prompted them to further explore the link between these two conditions. Dr Nitin Kumar Bajpai, Nephrologist and Additional Professor at AIIMS Jodhpur who had witnessed the profound impact of hypertension on the lives of individuals battling chronic kidney disease asserts that, “I can’t stress enough the urgency of understanding this connection. It’s not just about managing blood pressure; it’s about preserving hope, vitality, and the essence of life itself. Every moment counts in crafting treatment strategies that safeguard kidney function and enhance overall well-being.”
Hypertension, also known as high blood pressure, is a common health issue in India, affecting nearly one-third of the adult population. It is a major risk factor for kidney diseases, which could soon be the fifth leading cause of death in India, according to a study released by Nizam’s Institute of Medical Sciences in 2019. However, what is even more concerning is that many people with hypertension are unaware of their condition, making them more vulnerable to developing kidney diseases.
Hypertension also known as the silent killer can damage the blood vessels in the kidneys, reducing their ability to function properly. This can lead to a condition called chronic kidney disease (CKD), which is the gradual loss of kidney function over time. CKD can eventually progress to end-stage renal disease (ESRD), where the kidneys are no longer able to function at all.
Hypertension is both a cause and complication of kidney diseases, significantly affecting health related quality of life. Studies show that hypertensive individuals with CKD tend to have lower health related quality of life, especially in physical function domains.
Whether or not the initial cause of kidney disease is hypertension, increased blood pressure in the vessels of the kidneys will worsen the condition. It is a vicious cycle. The silent connection between hypertension and kidney diseases in India is a pressing issue that needs immediate attention. But before making lifestyle changes or adhering to treatment, hypertension requires diagnosis and awareness among people. “Despite the high prevalence of HTN, several studies have found low levels of awareness and control which suggests inadequate management of HTN,” says Ashim Sanyal, CEO of Consumer VOICE, a voluntary organisation working in the interest of consumer education and awareness.
At some point it becomes difficult to determine which disease process precedes the other, as both hypertension and CKD share similar risk factors including age, obesity, and comorbidities like diabetes or cardiovascular disease.
The relationship between hypertension and chronic kidney diseases is a complex one and intrinsically related. Hypertension is a strong determinant of worse renal and cardiovascular outcomes and renal function decline also aggravates hypertension. It is therefore imperative to achieve an optimal blood pressure (BP) target through several pharmacological and lifestyle measures.
Dr Pankaj Bhardwaj, Academic Head, School of Public Health and Professor, Community and Family Medicine, AIIMS Jodhpur. “I’ve seen many patients dealing with high blood pressure. It’s tough – keeping up with medications, changing habits. But, we don’t talk enough about how uncontrolled hypertension harms the kidneys and overall health, no matter your age. The longer the exposure, the greater the damage, hence making it critical for even youngsters to prioritize hypertension control. We need to focus on prevention, spotting early, and treatment.”
With Non-communicable diseases (NCDs) increasing drastically in India, accounting for almost 63 per cent of all deaths, the spotlight is now on identifying hypertension among patients with CKD and vice versa, and the traditional and novel aspects of hypertension management among CKD patients.