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Webcast Transcript
But here, again, the same issue applies, that the treatment of blood pressure requires that the blood pressure be actually controlled, so sometimes that takes more than one agent -- two, even three drugs -- to reach the target blood pressure control that we aim for.
How do we know we have that? I try to teach patients to measure their own blood pressure, because many times the readings that they have in the home setting or in their work setting are more reliable than the ones that they have in the doctor's office. They always talk about this "white coat effect" where the blood pressure is elevated in the doctor's office. It's substantially lower at home. What I try to do is train patients to measure their blood pressure frequently so they can get an average of what their readings are over a week's period.
LISA CLARK: I want to ask you specifically about some of the types of drugs that might be prescribed. ACE inhibitors -- are those particularly effective for people who also have kidney disease as well as hypertension?
JAI RADHAKRISHNAN, MD: Yes. The advantage of ACE inhibitors is that even if you don't have a high blood pressure, it reduces the pressure within the kidney and thereby reduces the stress on the kidney. So if you have a patient who has a high blood pressure and has kidney dysfunction, this is probably the first drug you should consider treating the patient with. There's also a sort of allied agent called ARB, or angiotensin receptor blocker, which is very similar to an ACE inhibitor and which may have less side effects. So both of these drugs are extremely important in treatment of patients with high blood pressure and kidney disease.
LISA CLARK: Is it ever a consideration that because kidney function is impaired and the system is not able to filter as effectively that you wouldn't choose certain types of drugs that might otherwise be used if there's just high blood pressure on the table?
LEONARD STERN, MD: These two drugs, the classes of drugs that we just talked about, the ACE inhibitors and the ARBs, are superb first-line agents for treatment of high blood pressure and for preservation of kidney function, but when kidney disease is far advanced, then these drugs have limited uses, because part of their mechanism of action is they impair the ability to excrete potassium.
LISA CLARK: Thank you, both of you, Dr. Leonard Stern, Dr. Jai Radhakrishnan, and thanks to you for joining us in our web audience. I'm Lisa Clark.
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