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QUOTE FOR MONDAY:

“Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behavior and development to make a diagnosis.

ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable.1 However, many children do not receive a final diagnosis until much older. This delay means that children with ASD might not get the early help they need.”

Centers for Disease Control and Prevention-CDC

Part II Month of Autism Awareness

What disorders are related to ASD?

Certain known genetic disorders are associated with an increased risk for autism, including Fragile X syndrome (which causes intellectual disability) and tuberous sclerosis (which causes benign tumors to grow in the brain and other vital organs) — each of which results from a mutation in a single, but different, gene. Recently, researchers have discovered other genetic mutations in children diagnosed with autism, including some that have not yet been designated as named syndromes. While each of these disorders is rare, in aggregate, they may account for 20 percent or more of all autism cases.

People with ASD also have a higher than average risk of having epilepsy. Children whose language skills regress early in life — before age 3 — appear to have a risk of developing epilepsy or seizure-like brain activity. About 20 to 30 percent of children with ASD develop epilepsy by the time they reach adulthood. Additionally, people with both ASD and intellectual disability have the greatest risk of developing seizure disorder.

How is ASD diagnosed?

ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps. Very early indicators that require evaluation by an expert include:

  • no babbling or pointing by age 1
  • no single words by age 16 months or two-word phrases by age 2.
  • no response to name
  • loss of language or social skills previously acquired
  • poor eye contact
  • excessive lining up of toys or objects
  • no smiling or social responsiveness

Later indicators include:

  • impaired ability to make friends with peers
  • impaired ability to initiate or sustain a conversation with others
  • absence or impairment of imaginative and social play
  • repetitive or unusual use of language
  • abnormally intense or focused interest
  • preoccupation with certain objects or subjects
  • inflexible adherence to specific routines or rituals

Health care providers will often use a questionnaire or other screening instrument to gather information about a child’s development and behavior. Some screening instruments rely solely on parent observations, while others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of ASD, a more comprehensive evaluation is usually indicated.

A comprehensive evaluation requires a multidisciplinary team, including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose and treat children with ASD. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for ASD, children with delayed speech development should also have their hearing tested.

What causes ASD?

Scientists believe that both genetics and environment likely play a role in ASD. There is great concern that rates of autism have been increasing in recent decades without full explanation as to why. Researchers have identified a number of genes associated with the disorder. Imaging studies of people with ASD have found differences in the development of several regions of the brain. Studies suggest that ASD could be a result of disruptions in normal brain growth very early in development. These disruptions may be the result of defects in genes that control brain development and regulate how brain cells communicate with each other. Autism is more common in children born prematurely. Environmental factors may also play a role in gene function and development, but no specific environmental causes have yet been identified. The theory that parental practices are responsible for ASD has long been disproved. Multiple studies have shown that vaccination to prevent childhood infectious diseases does not increase the risk of autism in the population.

What role do genes play?

Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, then the other will be affected between 36 to 95 percent of the time. There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD. In families with one child with ASD, the risk of having a second child with the disorder also increases. Many of the genes found to be associated with autism are involved in the function of the chemical connections between brain neurons (synapses). Researchers are looking for clues about which genes contribute to increased susceptibility. In some cases, parents and other relatives of a child with ASD show mild impairments in social communication skills or engage in repetitive behaviors. Evidence also suggests that emotional disorders such as bipolar disorder and schizophrenia occur more frequently than average in the families of people with ASD.

In addition to genetic variations that are inherited and are present in nearly all of a person’s cells, recent research has also shown that de novo, or spontaneous, gene mutations can influence the risk of developing autism spectrum disorder.  De novo mutations are changes in sequences of deoxyribonucleic acid or DNA, the hereditary material in humans, which can occur spontaneously in a parent’s sperm or egg cell or during fertilization. The mutation then occurs in each cell as the fertilized egg divides. These mutations may affect single genes or they may be changes called copy number variations, in which stretches of DNA containing multiple genes are deleted or duplicated.  Recent studies have shown that people with ASD tend to have more copy number de novo gene mutations than those without the disorder, suggesting that for some the risk of developing ASD is not the result of mutations in individual genes but rather spontaneous coding mutations across many genes.  De novo mutations may explain genetic disorders in which an affected child has the mutation in each cell but the parents do not and there is no family pattern to the disorder. Autism risk also increases in children born to older parents. There is still much research to be done to determine the potential role of environmental factors on spontaneous mutations and how that influences ASD risk.

Do symptoms of autism change over time?

For many children, symptoms improve with age and behavioral treatment. During adolescence, some children with ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood. People with ASD usually continue to need services and supports as they get older, but depending on severity of the disorder, people with ASD may be able to work successfully and live independently or within a supportive environment.

How is autism treated?

There is no cure for ASD. Therapies and behavioral interventions are designed to remedy specific symptoms and can substantially improve those symptoms. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of the individual. Most health care professionals agree that the earlier the intervention, the better.

Educational/behavioral interventions: Early behavioral/educational interventions have been very successful in many children with ASD. In these interventions therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as applied behavioral analysis, which encourages positive behaviors and discourages negative ones. In addition, family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.

Medications: While medication can’t cure ASD or even treat its main symptoms, there are some that can help with related symptoms such as anxiety, depression, and obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity in people with ASD. Parents, caregivers, and people with autism should use caution before adopting any unproven treatments

QUOTE FOR THE WEEKEND:

“Autism is a complex, lifelong developmental disability that typically appears during early childhood and can impact a person’s social skills, communication, relationships, and self-regulation. Autism is defined by a certain set of behaviors and is a “spectrum condition” that affects people differently and to varying degrees.

While there is currently no known single cause of autism, early diagnosis helps a person receive the support and services that they need, which can lead to a quality life filled with opportunity.”

Autism Society (www.autism-society.org)

Part I Month of Autism Awareness

 

What is autism spectrum disorder?

Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. The symptoms are present from early childhood and affect daily functioning.

The term “spectrum” refers to the wide range of symptoms, skills, and levels of disability in functioning that can occur in people with ASD. Some children and adults with ASD are fully able to perform all activities of daily living while others require substantial support to perform basic activities. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published in 2013) includes Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorders not otherwise specified (PDD-NOS) as part of ASD rather than as separate disorders. A diagnosis of ASD includes an assessment of intellectual disability and language impairment.

ASD occurs in every racial and ethnic group, and across all socioeconomic levels. However, boys are significantly more likely to develop ASD than girls. The latest analysis from the Centers for Disease Control and Prevention estimates that 1 in 68 children has ASD.

What are some common signs of ASD?

Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.

The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual.

Social impairment and communication difficulties
Many people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other people’s feelings or talk about their own feelings.

People with ASD may have very different verbal abilities ranging from no speech at all to speech that is fluent, but awkward and inappropriate. Some children with ASD may have delayed speech and language skills, may repeat phrases, and give unrelated answers to questions. In addition, people with ASD can have a hard time using and understanding non-verbal cues such as gestures, body language, or tone of voice. For example, young children with ASD might not understand what it means to wave goodbye. People with ASD may also speak in flat, robot-like or a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Repetitive and characteristic behaviors
Many children with ASD engage in repetitive movements or unusual behaviors such as flapping their arms, rocking from side to side, or twirling. They may become preoccupied with parts of objects like the wheels on a toy truck. Children may also become obsessively interested in a particular topic such as airplanes or memorizing train schedules. Many people with ASD seem to thrive so much on routine that changes to the daily patterns of life — like an unexpected stop on the way home from school — can be very challenging. Some children may even get angry or have emotional outbursts, especially when placed in a new or overly stimulating environment.

QUOTE FOR FRIDAY:

“Irritable bowel syndrome or IBS affects mostly women. Causes are unknown. IBS symptoms include diarrhea, constipation, and abdominal cramps. IBS treatments include diet and lifestyle changes and medications.”
 
Web MD

Part II Irritable Bowel Syndrome Awareness Month!

        

Treatments and drugs

Because it’s not clear what causes irritable bowel syndrome, treatment focuses on the relief of symptoms so that you can live as normally as possible.

In most cases, you can successfully control mild signs and symptoms of irritable bowel syndrome by learning to manage stress and making changes in your diet and lifestyle. Try to avoid foods that trigger your symptoms. Also try to get enough exercise, drink plenty of fluids and get enough sleep.

If your problems are moderate or severe, you may need more than lifestyle changes. Your doctor may suggest medications.

Dietary changes:

  • Eliminating high-gas foods. If you have bothersome bloating or are passing considerable amounts of gas, your doctor may suggest that you cut out such items as carbonated beverages, vegetables — especially cabbage, broccoli and cauliflower — and raw fruits.
  • Eliminating gluten. Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten (wheat, barley and rye). This recommendation remains controversial, and the evidence is not clear.
  • Eliminating FODMAPs. Some people are sensitive to types of carbohydrates such as fructose, fructans, lactose and others, called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). FODMAPs are found in certain grains, vegetables, fruits and dairy products. However, often people are not bothered by every FODMAP food. You may be able to get relief from your IBS symptoms on a strict low FODMAP diet and then reintroduce foods one at time.

Medications:

  • Fiber supplements. Taking fiber supplements, such as psyllium (Metamucil) or methylcellulose (Citrucel), with fluids may help control constipation. Fiber obtained from food may cause much more bloating compared with a fiber supplement. If fiber doesn’t help symptoms, your doctor may prescribe an osmotic laxative such as milk of magnesia or polyethylene glycol.
  • Anti-diarrheal medications. Over-the-counter medications, such as loperamide (Imodium), can help control diarrhea. Some people will benefit from medications called bile acid binders, such as cholestyramine (Prevalite), colestipol (Colestid) or colesevelam (Welchol), but these can lead to bloating.
  • Anticholinergic and antispasmodic medications. These medications, such as hyoscyamine (Levsin) and dicyclomine (Bentyl), can help relieve painful bowel spasms. They are sometimes used for people who have bouts of diarrhea, but they can worsen constipation and can lead to other symptoms, such as difficulty urinating. They should also be used with caution among people with glaucoma.
  • Antidepressant medications. If your symptoms include pain or depression, your doctor may recommend a tricyclic antidepressant or a selective serotonin reuptake inhibitor (SSRI). These medications help relieve depression as well as inhibit the activity of neurons that control the intestines.

If you have diarrhea and abdominal pain without depression, your doctor may suggest a lower than normal dose of tricyclic antidepressants, such as imipramine (Tofranil) or nortriptyline (Pamelor). Side effects of these drugs include drowsiness and constipation. SSRIs, such as fluoxetine (Prozac, Sarafem) or paroxetine (Paxil), may be helpful if you’re depressed and have pain and constipation.

  • Some people whose symptoms are due to an overgrowth of bacteria in their intestines may benefit from antibiotic treatment. Some people with symptoms of diarrhea have benefited from rifaximin (Xifaxan), but more research is needed.
  • You may benefit from counseling if you have depression or if stress tends to worsen your symptoms.

Medication specifically for IBS

Two medications are currently approved for specific cases of IBS:

  • Alosetron (Lotronex). Alosetron is designed to relax the colon and slow the movement of waste through the lower bowel. The Food and Drug Administration (FDA) removed it from the market for a time, but has since allowed alosetron to be sold again.

However, alosetron can be prescribed only by doctors enrolled in a special program and is intended for severe cases of diarrhea-predominant IBS in women who haven’t responded to other treatments. Alosetron is not approved for use by men. It has been linked to rare but important side effects, so it should only be considered when other treatments are not successful.

  • Lubiprostone (Amitiza). Lubiprostone works by increasing fluid secretion in your small intestine to help with the passage of stool. It is approved for women age 18 and older who have IBS with constipation. Its effectiveness in men is not proved, nor its long-term safety. Common side effects include nausea, diarrhea and abdominal pain. Lubiprostone is generally prescribed only for women with IBS and severe constipation for whom other treatments haven’t been successful.

 

QUOTE FOR WEDNESDAY:

“In the United States, it is estimated that 10-15 percent of the adult population suffers from IBS symptoms, yet only 5 to 7 percent of adults have been diagnosed with the disease. IBS is the most common disease diagnosed by gastroenterologists and one of the most common disorders seen by primary care physicians.”

American College of Gastroenterology

Part I Irritable Bowel Syndrome

 

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS is a chronic condition that you will need to manage long term.

Even though signs and symptoms are uncomfortable, IBS — unlike ulcerative colitis and Crohn’s disease, which are forms of inflammatory bowel disease — doesn’t cause changes in bowel tissue or increase your risk of colorectal cancer.

Only a small number of people with irritable bowel syndrome have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. Others will need medication and counseling.

The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:

  • Abdominal pain or cramping
  • A bloated feeling
  • Gas
  • Diarrhea or constipation — sometimes alternating bouts of constipation and diarrhea
  • Mucus in the stool
  • For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.

When to see a doctor:

Although as many as 1 in 5 American adults has signs and symptoms of irritable bowel syndrome, fewer than 1 in 5 who have symptoms seek medical help. Yet it’s important to see your doctor if you have a persistent change in bowel habits or if you have any other signs or symptoms of IBS because these may indicate a more serious condition, such as colon cancer.

Symptoms that may indicate a more serious condition or tell you see an MD even call 911:

  • Rectal bleeding
  • Abdominal pain that progresses or occurs at night
  • Weight loss

Causes of IBS:

The exact cause  of irritable bowel syndrome (IBS) has not been determined, although there are several theories. One theory is that IBS may be an immune disorder, or one in which the intestines of the affected person are highly sensitive in responding to stress and bacteria. Certain foods are thought to trigger IBS flare-ups, including dairy products and gluten, which is present in wheat, barley and rye.

The epithelial layer, or lining, of the large intestine controls the amount of fluid in the bowel. In IBS, there appears to be a disruption in the function of fluid absorption. This can result in excessive fluid in the colon, which causes diarrhea and watery stools. Or, if the lining of the colon absorbs too much fluid from the colon contents, the stool may become dry, leading to constipation.

The MAYO clinic says Triggers vary from person to person.

Stimuli that don’t bother other people can trigger symptoms in people with IBS — but not all people with the condition react to the same stimuli. Common triggers include:

  • Foods. The role of food allergy or intolerance in irritable bowel syndrome is not yet clearly understood, but many people have more severe symptoms when they eat certain things. A wide range of foods has been implicated — chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages and alcohol to name a few.
  • Stress. Most people with IBS find that their signs and symptoms are worse or more frequent during periods of increased stress, such as finals week or the first weeks on a new job. But while stress may aggravate symptoms, it doesn’t cause them.
  • Hormones. Because women are twice as likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.
  • Other illnesses. Sometimes another illness, such as an acute episode of infectious diarrhea (gastroenteritis) or too many bacteria in the intestines (bacterial overgrowth), can trigger IBS.

QUOTE FOR TUESDAY:

“Your kidneys and your circulatory system depend on each other for good health. The kidneys help filter wastes and extra fluids from blood, and they use a lot of blood vessels to do so. When the blood vessels become damaged, the nephrons (located in the kidneys) that filter your blood don’t receive the oxygen and nutrients they need to function well. This is why high blood pressure (HBP or hypertension) is the second leading cause of kidney failure.”

American Heart Association (AHA)

High Blood Pressure and Kidney Disease!

What is high blood pressure?

Blood pressure is the force of blood pushing against blood vessel walls as your heart pumps out blood. High blood pressure NIH external link, also called hypertension, is an increase in the amount of force that blood places on blood vessels as it moves through the body.

What are the kidneys and what do they do?

Healthy kidneys filter about a half cup of blood every minute, removing wastes and extra water to make urine. The urine flows from each kidney to the bladder through a pair of thin tubes called ureters, one on each side of your bladder. Your bladder stores urine. Your kidneys, ureters, and bladder are part of your urinary tract system.

How does high blood pressure affect the kidneys?

High blood pressure can constrict and narrow the blood vessels, which eventually damages and weakens them throughout the body, including in the kidneys. The narrowing reduces blood flow.

If your kidneys’ blood vessels are damaged, they may no longer work properly. When this happens, the kidneys are not able to remove all wastes and extra fluid from your body. Extra fluid in the blood vessels can raise your blood pressure even more, creating a dangerous cycle, and cause more damage leading to kidney failure.

How common are high blood pressure and kidney disease?

Almost 1 in 2 U.S. adults—or about 108 million people—have high blood pressure.1

More than 1 in 7 U.S. adults—or about 37 million people—may have chronic kidney disease (CKD).

High blood pressure is the second leading cause of kidney failure in the United States after diabetes, as illustrated in Figure 1.A pie chart showing the causes of kidney failure in the United States, with diabetes at 38%, high blood pressure at 26%, glomerulonephritis at 16%, other causes at 15%, and unknown causes at 5%.

Figure 1. Causes of kidney failure in the United States

Who is more likely to have high blood pressure or kidney disease?

High blood pressure

You are more likely to have high blood pressure if you

  • are older. Blood pressures tends to increase with age. Our blood vessels naturally thicken and stiffen over time.
  • have family members with high blood pressure. High blood pressure tends to run in families.
  • have unhealthy lifestyle habits. Unhealthy habits such as eating too much sodium (salt), drinking too many alcoholic beverages, or not being physically active can increase your risk of high blood pressure.
  • are African American. High blood pressure is more common in African American adults than in Caucasian, Hispanic, or Asian adults.
  • are male. Men are more likely to develop high blood pressure before age 55; women are more likely to develop it after age 55.

Kidney disease

In addition to high blood pressure, other factors that increase your risk of kidney disease are

  • diabetes
  • a family history of kidney failure
  • race or ethnicity—African Americans, Hispanics, and American Indians tend to have a greater risk for CKD

High blood pressure can be both a cause and a result of kidney disease.

What are the symptoms of high blood pressure and kidney disease?

Most people with high blood pressure do not have symptoms. In rare cases, high blood pressure can cause headaches.

Early CKD also may not have symptoms. As kidney disease gets worse, some people may have swelling, called edema. Edema happens when the kidneys cannot get rid of extra fluid and salt. Edema can occur in the legs, feet, ankles, or—less often—in the hands or face.

Symptoms of advanced kidney disease can include

  • loss of appetite, nausea, or vomiting
  • drowsiness, feeling tired, or sleep problems
  • headaches or trouble concentrating
  • increased or decreased urination
  • generalized itching or numbness, dry skin, or darkened skin
  • weight loss
  • muscle cramps
  • chest pain or shortness of breath

How do health care professionals diagnose high blood pressure and kidney disease?

High blood pressure

Blood pressure test results are written with the two numbers separated by a slash. The top number is called the systolic pressure and represents the pressure as the heart beats and pushes blood through the blood vessels. The bottom number is called the diastolic pressure and represents the pressure as blood vessels relax between heartbeats.

Your health care professional will diagnose you with high blood pressure if your blood pressure readings are consistently higher than 130/80 when tested repeatedly in a health care office.

Health care professionals measure blood pressure NIH external link with a blood pressure cuff. You can also buy a blood pressure cuff to monitor your blood pressure at home.

A health care professional measures the blood pressure of an older patient using a blood pressure cuff.
Health care professionals measure blood pressure with a blood pressure cuff.

Kidney disease

To check for kidney disease, health care professionals use

  • a blood test that checks how well your kidneys are filtering your blood, called GFR, which stands for glomerular filtration rate.
  • a urine test to check for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged.

If you have kidney disease, your health care professional will use the same two tests to monitor your kidney disease.

How can I prevent or slow the progression of kidney disease from high blood pressure?

The best way to slow or prevent kidney disease from high blood pressure is to take steps to lower your blood pressure. These steps include a combination of medicines and lifestyle changes, such as

  • being physically active
  • maintaining a healthy weight
  • quitting smoking
  • managing stress
  • following a healthy diet, including less sodium (salt) intake

No matter what the cause of your kidney disease, high blood pressure can make your kidneys worse. If you have kidney disease, you should talk with your health care professional about your individual blood pressure goals and how often you should have your blood pressure checked.

Medicines

Medicines that lower blood pressure can also significantly slow the progression of kidney disease. Two types of blood pressure-lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), may be effective in slowing the progression of kidney disease.

Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a health care professional may prescribe a diuretic—a medication that helps the kidneys remove fluid from the blood—or other blood pressure medications NIH external link.

Physical activity

Regular physical activity can lower your blood pressure and reduce your chances of other health problems.

Aim for at least 150 minutes per week of moderate-intensity aerobic activity. These activities make your heart beat faster and may cause you to breathe harder. Start by trying to be active for at least 10 minutes at a time without breaks. You can count each 10-minute segment of activity toward your physical activity goal. Aerobic activities include

  • biking (Don’t forget the helmet.)
  • swimming
  • brisk walking
  • wheeling yourself in a wheelchair or engaging in activities that will support you such as chair aerobics
An older couple biking in the countryside, wearing helmets.
Biking is one type of moderate-intensity exercise that can help lower your blood pressure and weight.

If you have concerns, a health care professional can provide information about how much and what kinds of activity are safe for you.

Body weight

If you are overweight or have obesity, aim to reduce your weight by 7 to 10 percent during the first year of treatment for high blood pressure. This amount of weight loss can lower your chance of developing health problems related to high blood pressure.

Body Mass Index (BMI) is the tool most commonly used to estimate and screen for overweight and obesity in adults. BMI is a measure based on your weight in relation to your height. Your BMI can tell if you are at a normal or healthy weight, are overweight, or have obesity.

  • Normal or healthy weight. A person with a BMI of 18.5 to 24.9 is in the normal or healthy range.
  • Overweight. A person with a BMI of 25 to 29.9 is considered overweight.
  • Obesity. A person with a BMI of 30 to 39.9 is considered to have obesity.
  • Extreme obesity. A person with a BMI of 40 or greater is considered to have extreme obesity.

Your goal should be a BMI lower than 25 to help keep your blood pressure under control.3

Smoking

If you smoke, you should quit. Smoking can damage blood vessels, raise the chance of developing high blood pressure, and worsen health problems related to high blood pressure.

If you have high blood pressure, talk with your health care professional about programs and products to help you quit smoking.

Stress

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Some activities that may help you reduce stress include

  • being physically active
  • practicing yoga NIH external link or tai chi NIH external link
  • listening to music
  • focusing on something calm or peaceful
  • meditating NIH external link
Older man and woman in exercise clothes stretching in a park.
Physical activity can reduce stress and lower blood pressure.

How does eating, diet, and nutrition affect high blood pressure and kidney disease?

Following a healthy eating plan can help lower your blood pressure. Reducing the amount of sodium in your diet is an important part of any healthy eating plan. Your health care professional may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan NIH external link. DASH focuses on fruits, vegetables, whole grains, and other foods that are healthy for your heart and lower in sodium, which often comes from salt. The DASH eating plan

  • is low in fat and cholesterol
  • features fat-free or low-fat milk and dairy products, fish, poultry, and nuts
  • suggests less red meat, sweets, added sugars, and sugar-containing beverages
  • is rich in nutrients, protein, and fiber
A variety of healthy, nutritious foods including vegetables, fruits, whole grains, cheese, eggs, milk, and chicken.
A healthy eating plan includes a variety of healthy, nutritious foods.

A registered dietitian can help tailor your diet to your kidney disease. If you have congestive heart failure or edema, a diet low in sodium intake can help reduce edema and lower blood pressure. Reducing saturated fat and cholesterol can help control high levels of lipids, or fats, in the blood.

People with advanced kidney disease should speak with their health care professional about their diet.

What should I avoid eating if I have high blood pressure or kidney disease?

If you have kidney disease, avoid foods and beverages that are high in sodium NIH external link.

Additional steps you can take to meet your blood pressure goals may include eating heart-healthy and low-sodium meals, quitting smoking, being active, getting enough sleep, and taking your medicines as prescribed. You should also limit alcoholic drinks—no more than two per day for men and one per day for women—because consuming too many alcoholic beverages raises blood pressure.

In addition, a health care professional may recommend that you eat moderate or reduced amounts of protein.

Proteins break down into waste products that the kidneys filter from the blood. Eating more protein than your body needs may burden your kidneys and cause kidney function to decline faster. However, eating too little protein may lead to malnutrition, a condition that occurs when the body does not get enough nutrients.

If you have kidney disease and are on a restricted protein diet, a health care professional will use blood tests to monitor your nutrient levels.