Researchers from the University of Virginia (UVA) School of Medicine have found that long-term use of some common high blood pressure medications can damage the kidneys and reduce their ability to filter blood.
These medications, called RAS inhibitors, are usually the first drugs doctors prescribe to treat high blood pressure.
They work by relaxing blood vessels, making it easier for blood to flow.
But the new research shows that over time, these medications may cause physical changes in the kidneys .
High blood pressure, also known as hypertension, affects more than 1.3 billion people worldwide.
If untreated, it can lead to serious health problems such as strokes, heart attacks, kidney failure, and even vision loss.
One important system in the body that helps regulate blood pressure is the renin-angiotensin system (RAS). When blood pressure drops, special cells in the kidney release a hormone-like enzyme called renin. RAS inhibitors block this system to help lower blood pressure.
While these drugs are usually effective and safe when taken under a doctor’s supervision, doctors have warned patients to report any signs of kidney problems, like swelling, low urination, or seizures. Until now, it wasn’t clear why these drugs sometimes led to kidney issues. The UVA researchers have found some answers.
The research shows that when RAS inhibitors are used for a long time, the kidney cells that normally produce renin become overactive. These cells change back into a more primitive, embryonic form. In this altered state, the cells grow too large and start releasing more renin and other harmful substances.
These changes can lead to the growth of extra nerves, buildup of immature muscle cells, and the formation of scar tissue around small kidney blood vessels, known as arterioles. Inflammatory cells also invade t…
Dr. Manako Yamaguchi, one of the researchers, explained that 3D imaging of the kidneys showed clear signs of nerve overgrowth, thickening of small arteries, and immune cell buildup after long-term RAS drug use.
All of these changes disrupt the kidney’s normal function of filtering waste from the blood. Even though the kidney may still try to help control blood pressure by producing more renin, its main job—cleaning the blood—is weakened.
Another researcher, Dr. Maria Luisa S. Sequeira-Lopez, said their next step is to understand exactly how these different types of kidney cells, nerves, and immune cells interact under the influence of RAS inhibitors. By doing so, they hope to discover new ways to treat high blood pressure without causing harm to the kidneys.
This discovery is important because it challenges the assumption that long-term use of RAS inhibitors is completely safe for kidney health.
It could lead to new medications or treatment plans that help people manage their blood pressure without risking kidney damage. The researchers believe this breakthrough will help shape better care for patients in the future.
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The study is published in Circulation Research.
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