Why Blood Pressure Matters for People with PKD
Cardiovascular complications are the leading cause of death for those with PKD.¹
I still remember the day I read that. I was shocked. As someone with a kidney disease, I thought I should focus on kidney health. It turns out heart and blood vessel health matters just as much, if not more.
Why is that?
The Cardiovascular System
The heart and blood vessels make up the cardiovascular system.
The heart pumps blood throughout the body via blood vessels. There are three main types of blood vessels: arteries, veins, and capillaries.
Arteries carry blood away from the heart.
Veins carry blood toward the heart.
Capillaries connect arteries and veins. Capillaries are the smallest blood vessels where oxygen and nutrients enter into your organ’s cells and waste is sent back out.
The cardiovascular system is responsible for transporting life-giving, body-restoring, oxygen-and-nutrient-carrying blood throughout the body.
In order to transport blood, the cardiovascular system requires blood pressure.
Blood pressure is the force exerted on the blood vessels to cause blood to move throughout the cardiovascular system.
Imagine using a long garden hose to transport water up a hill. Pressure in the hose makes it possible for water to travel up against gravity. Too little pressure, and the water can’t travel up the hose. Too much pressure, and the hose gets damaged.
Blood pressure works like that hose. Too little pressure, and blood doesn’t travel through the blood vessels. Too much pressure, and the walls of the blood vessels become weakened and stiff. This prevents the blood vessels from transporting blood as well.
So, we don’t want too much pressure, and we don’t want too little. What’s the right level of blood pressure?
We measure blood pressure with two numbers. You’ve probably seen these numbers before, something like: 120/80.
A healthy blood pressure range is when the top number is between 90-120 and the bottom number is between 60-80.
If your blood pressure is below 90/60, it’s called hypotension. Hypotension is the medical term for low blood pressure.
If your blood pressure is above 120/80, it’s called hypertension. Hypertension is the medical term for high blood pressure.²
Most folks with PKD struggle with hypertension, what’s known as a cardiovascular complication of PKD. A cardiovascular complication is just a catch-all term to describe heart and blood vessel problems that develop alongside another disease.
Hypertension is the most common cardiovascular complication in people with PKD. But hypertension can lead to additional complications: left ventricular hypertrophy, endothelial dysfunction, increased carotid intima-media thickness, atherosclerosis, and others.³
Now that we’ve gone over some basic anatomy, let’s return to the original question: why are cardiovascular complications the leading cause of death in people with PKD?
It turns out that kidneys are responsible for blood pressure regulation. PKD damages the kidneys, making people with PKD more likely to develop hypertension. Hypertension steadily damages the cardiovascular system, leading to more cardiovascular complications. Eventually, the cardiovascular system breaks down.
But it’s not all bad news! Modern medicine has gotten much better at treating kidney disease through dialysis and transplants. Fifty years ago, people with PKD were more likely to die from kidney failure. Now we have a higher chance of surviving kidney failure!
So why does blood pressure matter for people with PKD?
You can replace your kidneys, but you can’t replace your cardiovascular system. As someone with PKD, keeping your blood pressure in a healthy range is the number one step you can take to protect against cardiovascular damage.
In the next chapter, I’ll explain why people with PKD develop hypertension in the first place.
Table of Contents
- Cardiovascular abnormalities in autosomal-dominant polycystic kidney disease. Tevfik Ecder · Robert W. Schrier. Nature Reviews Nephrology. 2009.
- Different organizations have different standards for what is considered hypertension. For our purposes, focusing on getting blood pressure in the healthy range is so crucial that I consider anything above 120/80 hypertension.
- Don’t worry about what all these complications mean at the moment. Your doctor can help you understand your risk of developing these if you’d like to know more.
When you start to take steps to lower your blood pressure, it’s important that you don’t do too much at once and cause hypotension, low blood pressure. Talk with your doctor before doing anything to lower your blood pressure, especially if you’re taking blood pressure medication.
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