Dialysis as a blood pressure complication? 'Caution' for young hypertensive patients

A red light is lit on the management of 'young hypertension'. Most of the hypertensive patients in their 60s and over have been diagnosed with hypertension and know that they have high blood pressure, and treatment and control are well done. The rate of control is also very low. On the occasion of World Hypertension Day on May 17, we learned about the importance of high blood pressure management and chronic kidney disease, a terrible complication of high blood pressure.

■ 30 to 40 who are in the blind spot of high blood pressure treatment

According to the results of analysis of the 7th National Health and Nutrition Examination Survey (2016-2018) by the Korean Society of Hypertension, the awareness rate of hypertension in their 40s decreased from 47.7% to 44.8%, the treatment rate decreased from 38.8% to 38.2%, and the control rate was 27.9%. There was no significant change from % to 29.1%.

Relatively younger patients do not know that they have high blood pressure, they do not receive treatment, and even if they receive treatment, their blood pressure is not well controlled. High blood pressure is difficult for patients to recognize because there are no symptoms, and even if high blood pressure is known through a health checkup, it seems that there will be no major problems as a young person, so they are passive in treatment. For this reason, the Korean Society of Hypertension has also set the slogan for this year's World Hypertension Day as 'Find young hypertension'.

■ Horrible complications of hypertension without symptoms… Fatal to the kidneys where capillaries gather

It is well known that high blood pressure, if left untreated, can lead to cardiovascular diseases such as arteriosclerosis, myocardial infarction, arrhythmia, and stroke, which can lead to death. Not only this, but also adversely affects the ‘kidney’, which acts like a water tank in our body.

The kidneys are made up of glomeruli, a collection of thin blood vessels that act like a filter to filter out waste products and keep the blood clean. However, if high blood pressure persists for a long time, the blood vessels that cannot withstand the pressure are damaged. The filtration function is reduced due to damage to the blood vessels, which leads to a decrease in kidney function.

In fact, high blood pressure was found to be the cause of 20% of dialysis patients in Korea, and the number of patients undergoing dialysis due to hypertension is also continuously increasing. In particular, if you have high blood pressure at a young age in your 30s or 40s, you should suspect the possibility of high blood pressure accompanied by kidney disease. Decreased kidney function and accompanied by proteinuria can be confirmed relatively easily through blood tests and urine tests. If either proteinuria over a certain period of time or kidney function falls below 60% of normal, it is considered chronic kidney disease.

■ Dialysis as a complication of hypertension… Early and active treatment and management are important

Younger patients tend to be reluctant to treat high blood pressure because of the perception that once they start taking medication, they have to keep taking it. If this persists, the drug may be reduced or discontinued.

If the kidney function is already reduced due to high blood pressure, you should make a careful decision in consultation with your doctor before taking the drug. If left untreated, chronic kidney disease progresses and kidney function continues to decline, eventually requiring kidney replacement therapy such as dialysis or organ transplantation.

“The quality of life of dialysis patients drops to half that of normal people,” said Shin Moon-hang, head of the department of nephrology at the Korea Hospital. “There aren’t many patients who come in,” he said.

He continued, “Even if the renal function declines considerably, there is no particular abnormality in the body, so it is considered as insignificant.” It's like a train moving towards you. I hope that the train will stop by practicing active treatment and health management.”

*reference original article : http://www.hankookhospital.co.kr/MedicalNews/46219