Long-term use of blood pressure drugs may cause kidney damage, study
suggests

Date:
January 12, 2022
Source:
University of Virginia Health System
Summary:
New kidney research is raising concerns that long-term use of ACE
inhibitors and other drugs commonly prescribed to treat high-blood
pressure and heart failure could be contributing to kidney damage.



FULL STORY ==========================================================================
New kidney research from the University of Virginia School of Medicine
is raising concerns that long-term use of drugs commonly prescribed to
treat high- blood pressure and heart failure could be contributing to
kidney damage.


========================================================================== Patients should continue taking the medications, which include the
well-known and widely used ACE inhibitors, the researchers say. But
the scientists are urging studies to better understand the drugs'
long-term effects.

"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," said
Maria Luisa Sequeira Lopez MD, of UVA's Department of Pediatrics and Child Health Research Center. "What is needed is to identify what substances
these cells make that lead to uncontrolled vessel growth." The Causes
of Kidney Damage Chronic high blood pressure affects a billion people
around the world. The UVA researchers wanted to better understand why
severe forms of the condition are often accompanied by thickening of the arteries and small blood vessels in the kidney, leading to organ damage.

They found that specialized kidney cells called renin cells play an
important role. These cells normally produce renin, a vital hormone that
helps the body regulate blood pressure. But harmful changes in the renin
cells can cause the cells to invade the walls of the kidney's blood
vessels. The renin cells then trigger a buildup of another cell type,
smooth muscle cells, that cause the vessels to thicken and stiffen. The
result: Blood can't flow through the kidney as it should.

Further, the researchers found, long-term use of drugs that inhibit
the renin- angiotensin system, such as ACE inhibitors, or angiotensin
receptor blockers, have a similar effect. These drugs are widely used
for many purposes, including treating high blood pressure, congestive
heart failure and heart attacks, as well as to prevent major heart
problems. But long-term use of the drugs was associated with hardened
kidney vessels in both lab mice and humans, the scientists found.

The researchers note that the medications can be lifesaving for patients,
so they stress the importance of continuing to take them. But they say additional studies are needed to better understand the drugs' long-term
effects on the kidneys.

"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," said 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." Findings Published
The researchers have published their findings in the scientific journal
JCI Insight. The article was selected as a cover story. The research team consisted of Hirofumi Watanabe, Alexandre G. Martini, Evan A. Brown,
Xiuyin Liang, Silvia Medrano, Shin Goto, Ichiei Narita, Lois J. Arend, Sequeira-Lopez and Gomez.

The research was supported by the National Institutes of Health, grants
P50 DK 096373, R01 DK 116718, R01 DK 116196, R01 DK 096373 and R01 HL
148044; and the Japan Society for the Promotion of Science Overseas
Research Fellowships.

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University_of_Virginia_Health_System. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Hirofumi Watanabe, Alexandre G. Martini, Evan A. Brown, Xiuyin
Liang,
Silvia Medrano, Shin Goto, Ichiei Narita, Lois J. Arend, Maria
Luisa S.

Sequeira-Lopez, R. Ariel Gomez. Inhibition of the renin-angiotensin
system causes concentric hypertrophy of renal arterioles in mice and
humans. JCI Insight, 2021; 6 (24) DOI: 10.1172/jci.insight.154337 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220112094027.htm
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