Common High Blood Pressure Drugs May ⁣Cause Kidney Damage

‌ ⁣ Updated‌ June 08, 2025
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Long-term treatment for high blood pressure using widely prescribed medications may impair the kidney’s ability to filter blood, according to researchers‍ at the University‍ of‌ Virginia School of Medicine. The findings⁢ shed light on how renin-angiotensin system (RAS) inhibitors, while effectively managing ⁣hypertension, can negatively impact kidney ​function ⁣over time.

RAS⁣ inhibitors relax blood vessels by blocking the renin ⁢enzyme. Doctors​ often⁤ prescribe them as a first-line treatment for hypertension, also known as high blood pressure. However, prolonged use can lead to⁢ kidney‌ damage, including scarring and functional changes that​ shift the organ’s focus ‍from filtration to renin‍ production.

Researchers describe the altered kidney as a “pathological neuro-immune endocrine organ” that can ⁤trigger serious health issues. R. ariel Gomez,⁣ MD, of UVA’s Child Health Research center, said the team’s discovery could ‍pave the way for methods to protect the kidneys and improve hypertension treatment. “The most commonly used and believed-to-be safe blood pressure medications may be damaging ⁢the kidneys,” Gomez ⁤said.‌ “We need‌ to accurately ‌understand⁤ the effects of long-term use‍ of RAS inhibitors on the kidneys.”

High⁤ blood pressure affects over‍ 1.3 billion peopel globally, forcing the heart to work harder‍ and potentially ⁤leading to stroke, heart attack, kidney damage, and⁣ vision loss. ‍The RAS system regulates blood pressure, with renin, a hormone enzyme produced by kidney cells, playing a crucial role.

While ⁢RAS inhibitors are generally safe under medical supervision,patients are advised to seek medical attention if they experience​ signs of kidney damage,such as reduced urination,swelling in the legs or feet,or seizures.

The UVA study⁣ reveals that excessive stimulation of renin-producing cells⁢ causes them to revert to‍ an ⁤invasive, embryonic state.These cells then grow too ​large and secrete⁤ renin‌ and other substances that trigger nerve growth, smooth muscle cell ‍buildup, scarring around arterioles, ⁣and inflammatory cell infiltration. This results​ in vascular disease, ​according to the researchers.

Manako Yamaguchi, PhD, another researcher, ⁢explained ⁢that⁢ 3D imaging showed long-term RAS⁢ inhibition​ leads to ‌hyperinnervation of renal arteries, arteriolar ‍hypertrophy, ⁣and immune ⁢inflammatory cell infiltration. “This neuro-immune-endocrine cooperation synergistically promotes⁣ increased production of renin to maintain blood pressure homeostasis, but, conversely, severe arteriolar hypertrophy reduces the blood filtration function of the ⁣kidney,” yamaguchi said.

Maria Luisa S. Sequeira-Lopez, MD, said understanding the causes of these harmful changes ‌could lead to ways to prevent them. “Our⁤ next goal‌ is to elucidate the whole picture of the⁢ interactions between renin cells,⁤ smooth muscle cells, nerves and inflammatory cells under RAS inhibition,” said Sequeira-Lopez.”These findings may open new avenues for the prevention of adverse⁤ effects when‌ treating hypertension.”

What’s next

Further research will focus on the⁤ interactions between kidney cells, nerves, and inflammatory cells‌ during RAS inhibition ⁤to develop strategies for preventing adverse effects of hypertension treatment and improving kidney health.