Southland Renal Medical Group
Controlling your Blood Pressure

Having high blood pressure puts you more at risk for kidney disease.  Keep a healthy blood pressure to help prevent or slow kidney disease.  You will need to:

> Check your blood pressure

High blood pressure can damage your kidneys.  Keeping your blood pressure in a healthy range can help protect your kidneys and prevent or slow kidney disease.  A heart-healthy diet, exercise and medicines can help you keep a healthy blood pressure.

You may need to check your blood pressure on a regular basis to know how you’re doing.

> Checking your blood pressure at home

Your doctor may suggest that you check your blood pressure at home.  The easiest way to do this is with a digital blood pressure monitor.  You can get a monitor from your local drug store, hospital, clinic or online.  Your doctor can help you find a monitor that is right for you.  Many pharmacies also have in-store monitors that you can use for free.

Your blood pressure monitor will come with directions for how to check your blood pressure.  Take your monitor to your next doctor visit so that your doctor can help make sure you are using it correctly.

When you check your blood pressure, your result will be given as two numbers.  Both numbers are important.

  • The first or top number is your systolic pressure.  This is when your heart is beating and your blood pressure is at its highest.
  • The second or bottom number is your diastolic pressure.  This is when your heart is between beats and your blood pressure is at its lowest.
    Example: 120 (Systolic)/80 (Diastolic)

For most people, a normal blood pressure is less than 120/80 or “120 over 80.”  If either number is high, your blood pressure is high.  Ask your doctor what your blood pressure should be.

Eat a Healthy Diet

What you eat can affect your blood pressure.  Pick foods low in salt (sodium) and fat to help keep your blood pressure in a healthy range.  Use these tips to get started:

> Limit Salt
  • Do not add salt to your food when cooking or eating.  Try cooking with fresh herbs, lemon juice or other spices.
  • Choose fresh or frozen vegetables instead of canned vegetables.  If you do use canned vegetables, rinse them before eating or cooking with them to remove extra salt.
  • Shop for items that say “reduced-sodium” or “low-sodium.”
  • Avoid processed foods like frozen dinners and lunch meats.
  • Limit fast food and salty snacks, like chips, pretzels and salted nuts.

> Reduce fat
  • Choose lean meats or fish.  Remove the skin and trim the fat off your meats before you cook them.
  • Bake, grill or broil your foods instead of frying them.
  • Shop for fat-free and low-fat dairy products, salad dressing and mayonnaise.
  • Try olive oil or canola oil instead of vegetable oil.
  • Choose egg whites or egg substitute rather than whole eggs.

> What about blood pressure medication?

If changes to your lifestyle are not enough to control your blood pressure, your doctor may prescribe a blood pressure medicine. There are many types of blood pressure medicines, and you may need to be on more than one medicine to control your blood pressure. Whichever medicine(s) you use, the most important thing is getting your blood pressure into a healthy range.

ACE inhibitors and ARBs are two types of blood pressure medicines that can help protect your kidneys. Ask your doctor if an ACE inhibitor or ARB is right for you. Your doctor might also prescribe a diuretic (also called a “water pill”). This is a type of medicine that helps your body get rid of extra fluid. Having too much fluid in your body can raise your blood pressure.

If your doctor prescribes medicines, take them as directed. Blood pressure medicines need to be taken even when you feel fine. If you have side effects from a medicine, talk to your doctor. He or she may suggest a different medicine that does not have those side effects.

> Living a healthy lifestyle

Keeping a healthy blood pressure is key to keeping your kidneys healthy.  You can also help protect your kidneys by following other healthy habits.  Try to:

  • Be physically active
  • Keep a healthy weight
  • Control your cholesterol
  • Avoid tobacco
  • Limit alcohol

> What about Calories?

Your body gets energy from the calories you eat and drink. Calories come from the protein, carbohydrates and fat in your diet. How many calories you need depends on your age, sex, body size and activity level.

You may also need to adjust how many calories you eat based on your weight goals. Some people will need to limit the calories they eat. Others may need to have more calories. Your doctor or dietitian can help you figure out how many calories you should have each day. Work with your dietitian to make a meal plan that helps you get the right amount of calories, and keep in close contact for suport and follow-up.

> What about Protein?

Protein is one of the building blocks of your body. Your body needs protein to grow, heal and stay healthy. Having too little protein can cause your skin, hair and nails to be weak. But having too much protein can also be a problem. To stay healthy and help you feel your best, you may need to adjust how much protein you eat.

The amount of protein you should have depends on your body size, activity level and health concerns. Some doctors recommend that people with kidney disease limit protein or change their source of protein. This is because a diet very high in protein can make the kidneys work harder and may cause more damage. Ask your doctor or dietitian how much protein you should have and what the best sources of protein are for you.

Use the table below to learn which foods are low or high in protein. Keep in mind that just because a food is low in protein, it is not healthy to eat unlimited amounts.

 Lower-protein foods

 Higher-protein foods

 Bread

 Meat

 Fruits

 Poultry

 Vegetables

 Fish

 Pasta and rice

 Eggs

 

> What about Carbohydrates?

Carbohydrates (“carbs”) are the easiest kind of energy for your body to use. Healthy sources of carbohydrates include fruits and vegetables. Unhealthy sources of carbohydrates include sugar, honey, hard candies, soft drinks and other sugary drinks.

Some carbohydrates are high in potassium and phosphorus, which you may need to limit depending on your stage of kidney disease. We’ll talk about this in more detail a little later. You may also need to watch your carbohydrates carefully if you have diabetes. Your dietitian can help you learn more about the carbohydrates in your meal plan and how they affect your blood sugar.

> What about Fat?

You need some fat in your meal plan to stay healthy. Fat gives you energy and helps you use some of the vitamins in your food. But too much fat can lead to weight gain and heart disease. Try to limit fat in your meal plan, and choose healthier fats when you can.

Healthier fat or “good” fat is called unsaturated fat. Examples of unsaturated fat include:

  • Olive oil
  • Vegetable oils

Unsaturated fat can help reduce cholesterol. If you need to gain weight, try to eat more unsaturated fat. If you need to lose weight, limit the unsaturated fat in your meal plan. As always, moderation is the key. Too much “good” fat can also cause problems.

Saturated fat, also known as “bad” fat, can raise your cholesterol level and put you at risk for heart disease. Examples of saturated fats include:

  • Butter
  • Lard
  • Shortening
  • Meats

Limit these in your meal plan. Choose healthier, unsaturated fat instead. Trimming the fat from meat and removing the skin from chicken or turkey can also help limit saturated fat.

> What about Sodium?

Sodium (salt) is a mineral found in almost all foods. Too much sodium can make you thirsty, which can lead to swelling and raise your blood pressure. This can damage your kidneys more and make your heart work harder.

One of the best things that you can do to stay healthy is to limit how much sodium you eat. To limit sodium in your meal plan:

  • Do not add salt to your food when cooking or eating. Try cooking with fresh herbs, lemon juice or other salt-free spices.
  • Choose fresh or frozen vegetables instead of canned vegetables. If you do use canned vegetables, drain and rinse them to remove extra salt before cooking or eating them.
  • Avoid processed meats like ham, bacon, sausage and lunch meats.
  • Munch on fresh fruits and vegetables rather than crackers or other salty snacks.
  • Avoid canned soups and frozen dinners that are high in sodium.
  • Avoid pickled foods, like olives and pickled.
  • Limit high-sodium condiments like soy sauce, BBQ sauce and ketchup

Exercise

Exercise has many known benefits for the general population. For individuals living with chronic kidney disease, exercise is particularly important due to the fact that patients with CKD are more physically inactive, have reduced physical functioning leading to poor quality of life, and have significantly reduced oxygen consumption. Additionally, patients with CKD have other chronic diseases such as diabetes, high blood pressure and cardiovascular disease for which exercise becomes very valuable.

The potential benefits of exercise include:
• Improvement in blood pressure control
• Better control of diabetes
• Improvement in lipid profiles
• Improved mental health
• Increase strength
• Healthier body weight
• Better sleep

Before starting an exercise program, talk to your doctor.

Types of exercise:
• Stretching- these exercises improves joint and muscle movement
• Aerobic exercise- involves activities that raise heart rate which increase blood flow through the heart.

Examples are walking, running, and swimming
• Resistance training- this type of exercise increase muscle strength through the use of weights, exercise bands.

All three types of exercise should be included in an exercise program.

Each exercise session should start with a 5 to 10 minute warm up period such as walking and stationary cycling. This helps by gradually increasing the heart and rate and to prevent injuries.

It is important to start slow and progress gradually to allow your body to adapt to the increased levels of exercise activity.

> Aerobic exercise

Exercises include walking, cycling, rowing and stair machine climbing. For people with arthritis, a low impact activity such as swimming is a good option to prevent physical injury.

If you don’t exercise regularly, start by exercising a few minutes at a low intensity. Gradually increase the time and frequency.

Exercise for at least 30 minutes a day, three times a week on non-consecutive days (such as Monday, Wednesday, Friday).

> Resistance training

Exercises are done with weights, machines and exercise bands. Involves doing “sets” and “repetition.” Start with minimal resistance with light weights to allow muscles and tissue to become accustomed to this type of exercise. Perform exercises every other day.

> When to exercise?

• Wait at least an hour after a meal
• Avoid exercising less than an hour before you go to bed
• Avoid exercising when the weather is very hot

> Avoid exercising when:

• When you have a fever
• Change in your medication regimen
• Changes in your physical condition
• You have pain in your joint or bones

> Stop exercising when you:

• Are short of breath
• Feel chest pain
• Feel tired
• Feel palpitations or irregular heart beat
• Stomach pain or nausea
• Feel dizzy or light-headed