Resistant and Reno vascular Hypertension Treatment In Hyderabad

What Is Hypertension?

Hypertension (high blood pressure) is a leading cause of kidney disease and kidney failure (end-stage renal disease). Hypertension can damage the blood vessels and filters in the kidney, making the removal of waste from the body difficult. When an individual is diagnosed with end-stage renal disease, dialysis or kidney transplantation is required.

What Is Resistant Hypertension?

Resistant hypertension is high blood pressure that can’t be controlled despite medications. Hypertension is considered resistant when all of the following conditions are met:

• Three different blood pressure medications are being taken at their maximum tolerated doses.
• A diuretic is one of the blood pressure medications (removes fluid and salt from the body).
• Blood pressure remains higher than your target—(usually 130/80 mmHg, but individual goals should be discussed with your doctor)
• Resistant hypertension occurs when hypertension requires four or more medications to control. Resistant hypertension significantly increases the risk of heart attack, stroke, and kidney failure.

Resistant hypertension increases the risk of heart attack, stroke, and kidney failure significantly.

Symptoms of Resistant Hypertension:

Hypertension can exist without any symptoms. The best way to know if you have high blood pressure is to have it checked by a health care provider.

Symptoms can occur when blood pressure first starts to rise or during a hypertensive crisis, when levels are extremely high.

• Severe headaches
• Severe anxiety
• Shortness of breath
• Chest pain
• Nosebleeds

Causes of Resistant Hypertension:

• Physical inactivity
• Obesity
• A diet high in salt
• Heavy alcohol intake
• Painkiller medications, especially NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen and naproxen
• Nasal decongestants
• Oral contraceptives (birth control pills)
• Ginseng, licorice or other herbal products
• Sleep apnea
• Renal (kidney) artery stenosis
• Coarctation of the aorta
• Kidney failure
• Chronic kidney disease
• Pheochromocytoma, an adrenal gland tumour, aortic narrowing, and Cushing syndrome, an overproduction of some steroid hormones, are less common causes.

Who is at risk for developing resistant hypertension?

You’re more likely to have resistant hypertension if you:

• Are of older age.
• Have chronic kidney disease.
• Have diabetes.
• having obesity
• a lack of activity or exercise
• smoking

Diagnosis of resistant hypertension?

To diagnose resistant hypertension, a doctor will:

• perform a physical exam
• take a full history
• measure a person’s blood pressure
• test for secondary conditions
• electrocardiogram (EKG)
• chest X-ray
• echocardiogram
• urinalysis
• fundoscopic eye exam to check for damaged blood vessels in the eye

Treatment For Resistant Hypertension

Our specialized doctors take the time to understand why you have high blood pressure and how it affects your health. We may discover that established resistant hypertension treatment approaches can effectively treat you.

Medications:

Depending on the results of diagnostic tests, medication will be reassessed, and surgery may be considered following an evaluation for resistant hypertension.

Lifestyle Changes

Changes may be suggested to reduce overall hypertension, and This includes maintaining a low-sodium diet, keeping a home blood pressure log, attending educational workshops, reducing or managing stress, limiting alcohol consumption, and quitting smoking.

Renal Denervation

Renal denervation is a new treatment for resistant hypertension that targets the blood pressure-regulating nerves near the kidneys. Surgeons once attempted to relieve hypertension by severing these renal artery nerves, which resulted in lowering blood pressure too far.

What is Renovascular Hypertension?

Renovascular hypertension is a leading cause of secondary hypertension and frequently leads to resistant hypertension. It is defined as systemic hypertension caused by a compromised blood supply to the kidneys, usually due to an occlusive lesion in the main renal artery. Renovascular hypertension is high blood pressure (greater than 140/80 mmHg) caused by renal artery disease. This condition is also called renal artery stenosis.

Renovascular hypertension patients may have a history of very high blood pressure that is difficult to control with medications.

Renovascular hypertension symptoms include:

• High blood pressure at a young age
• High blood pressure that suddenly worsens to control
• Kidneys that are not working well
• Narrowing of other arteries in the body, including those in the legs, brain, eyes, and elsewhere
• Sudden build-up of fluid in the air sacs of the lungs (pulmonary edema)
• Bad headache
• Nausea or vomiting
• Confusion
• Changes in vision
• Nosebleeds

Causes:

Renal artery stenosis is a narrowing or blockage of the arteries that supply the kidneys with blood.

The most common cause of renal artery stenosis is an artery blockage caused by high cholesterol. This issue arises when a sticky, fatty substance known as plaque accumulates on the inner lining of the arteries, causing a condition known as atherosclerosis.

Less blood flows to the kidneys when the arteries that carry blood to them become narrow. The kidneys mistakenly respond as if your blood pressure is low. As a result, they release hormones that instruct the body to store more salt and water. This causes your blood pressure to rise.

Risk factors for atherosclerosis:

• High blood pressure at a young age
• High blood pressure
• Diabetes
• Smoking
• High cholesterol levels
• Heavy alcohol consumption
• Cocaine addiction
• Growing older

Another cause of renal artery stenosis is fibro muscular dysplasia. It is most common in women under the age of 50. It tends to run in families. The condition is caused by abnormal cell growth in the walls of the arteries that lead to the kidneys. This causes narrowing or blockage of the arteries.

How is renal hypertension diagnosed?

• Blood Tests
• Angiotensin converting enzyme (ACE) inhibition renography
• Angiotensin converting enzyme (ACE) inhibition renography
• Duplex ultrasound
• Computerized tomographic angiography, or CTA
• Magnetic resonance angiogram, or MRA
• contrast angiography

Possible Complications:

• Aortic aneurysm
• The heart attack
• Heart failure
• Chronic kidney disease
• Stroke
• Vision issues
• Poor blood supply to the legs

Renovascular Hypertension Treatment:

Renovascular disease can be fatal if not treated. Fortunately, there is treatment available. The renovascular hypertension treatment goal is to keep blood pressure under control and prevent kidney failure.

The goal is to lower your blood pressure. In renal vascular hypertension, two specific types of medications may work better to control your blood pressure:

• Angiotensin-converting enzyme (ACE) inhibitors.
• Angiotensin receptor blockers (ARBs).

Lifestyle Changes

If you smoke, your healthcare team will advise you to quit. You will also be asked to change your diet and increase your physical activity to improve your heart health. Maintaining healthy lifestyle habits has been proven to help.

Medicine

Renal hypertension treatment for high blood pressure often begins with lifestyle changes. Aspirin, cholesterol-lowering medications, and medications for other conditions may also be included. High blood pressure medications are very effective at controlling blood pressure, but the disease can progress to block arteries. Your medical team will aim to prevent the loss of kidney tissue and progressive kidney failure. This is more difficult if renal artery stenosis hurts both kidneys.

Surgical Procedures

If you require additional treatment for renal hypertension, your doctor may advise you to undergo surgery. Endovascular procedures are used to clear obstructions in the kidney arteries. These treatments have the potential to improve blood flow to your kidneys. When blood flow returns, your kidneys can function, and high blood pressure may lower.

Balloon angioplasty

Balloon angioplasty is a common treatment for renal artery blockages. It is performed inside the blood vessel using a tiny balloon attached to the end of a small, flexible tube called a catheter. A renal artery stent may be placed in patients with atherosclerotic disease. Research shows this helps for a while, but more treatment may be required in the long run.

Surgical revascularization

Surgical revascularization (renewal of blood flow) may be required. It is used when medicine, balloon angioplasty, and stent placement are insufficient. When kidney failure is discovered, this is also used. Many surgical procedures are available to restore blood flow. Aortorenal bypass grafts, for example, and extra-anatomic bypass procedures.

If you require a more complex treatment of renovascular hypertension, known as bench surgery. This includes a kidney transplant as well as renal vessel reconstruction.

Our doctor DR PRANITH RAM, Best Nephrologist in Hyderabad, regularly cares for challenging cases of resistant hypertension & Renovascular Hypertension. Our Renal Hypertension Treatment Doctors team has the expertise to determine whether lifestyle changes and medications can help protect your health. In our renal hypertension centre, We also explore new options for treating hypertension that has not responded to existing treatments.