Common blood pressure drugs may damage a patient’s kidneys

CHARLOTTESVILLE, Va. — Long-term use of common blood pressure and heart failure drugs may contribute to kidney failure, according to a concerning new report by a team at the University of Virginia.

Despite their findings, study authors recommend patients continue to take the drugs in question, which include ACE inhibitors. In the meantime, they add that further work is necessary to definitively establish the long-term effects of certain prescription medications.

“Our studies show that renin-producing cells are responsible for the damage. We are now focusing on understanding how these cells, which are so important to defend us from drops in blood pressure and maintain our well-being, undergo such transformation and induce kidney damage,” says Dr. Maria Luisa Sequeira Lopez, of UVA’s Department of Pediatrics and Child Health Research Center, in a university release. “What is needed is to identify what substances these cells make that lead to uncontrolled vessel growth.”

Chronic high blood pressure is very common, affecting about a billion people all over the globe. Curiously, though, certain patients dealing with severe cases of hypertension gradually develop thicker arteries and smaller blood vessels within their kidneys. Researchers wanted to figure out why.

High blood pressure drugs react poorly with kidney cells

Their investigation quickly pointed in the direction of renin cells, or specialized kidney cells. These cells usually work to produce renin, a vital hormone that is essential when it comes to regulating blood pressure. However, changes to renin cells can result in them invading and attacking the walls of the kidney’s blood vessels. From there, the faulty renin cells foster the buildup of smooth muscle cells, which eventually leads to vessel thickening and stiffening. The end result of all this is usually blood being unable to flow through the kidneys as intended.

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Notably, researchers also discovered that long-term use of any drug that inhibits the renin-angiotensin system — such as ACE inhibitors or angiotensin receptor blockers — results in a similar effect. It’s important to note that doctors often prescribe these drugs for other heart issues including congestive heart failure and heart attacks as well.

All in all, researchers conclude long-term use of certain medications show a connection to hardening kidney vessels in both rodents and humans. Still, this subject isn’t as cut and dry as “don’t take these drugs,” researchers stress. These meds save lives, and the research team recommends that heart patients continue to follow their doctor’s guidance. Only further research will provide greater clarity.

“It would be important to conduct prospective, randomized controlled studies to determine the extent of functional and tissue damage in patients taking medications for blood pressure control,” concludes Ariel Gomez, MD, of UVA’s Department of Pediatrics and Child Health Research Center. “It is imperative to find out what molecules these cells make so that we can counteract them to prevent the damage while the hypertension is treated with the current drugs available today.”

The findings appear in the journal JCI Insight.

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John Anderer

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