Heart Health and Blood Pressure

What is cardiovascular disease?

Cardiovascular diseases are described as problems with the heart and blood vessels throughout the body, including brain, lungs, and legs. Heart and blood vessel diseases are common in people with chronic kidney disease (CKD). Over time, the build-up of cells, fats, and cholesterol may cause blockage to the blood vessels that bring blood to the heart and brain. This reduction in blood flow may possibly cause heart attacks and strokes.

Types of Heart and Blood Vessel Diseases

Here are some of the most common cardiovascular diseases to watch closely for.

  • Coronary artery disease: This is the most common form of heart disease. It affects the blood vessels of the heart, and causes angina (chest pain) and heart attacks.
  • Left ventricular hypertrophy: This is a condition where the muscle on the left side of the heart becomes thicker and causes inefficiency in pumping.
  • Heart failure: The heart is not able to pump blood around the body as well as it should. Heart failure develops slowly over time. It can have a large impact on the ability to perform daily activities.
  • Stroke: This is described as the sudden loss of brain function due to lack of blood flow to the brain. A stroke may be caused by a blood clot or bleeding in the brain from a broken blood vessel.

Do dialysis patients have an increased risk for heart and blood vessel disease?

Yes. Dialysis patients are much more likely than the general population to develop heart and blood vessel disease. This increased risk is related to kidney disease and other health problems like diabetes and high blood pressure. For this reason, it’s very important for dialysis patients to take note of the following steps that will help prevent heart and blood vessel problems.

How do I keep my heart healthy while on kidney dialysis?

  1. If you have diabetes, control your blood sugar levels carefully
    • Check your blood sugar as often as your doctor asks you to.
    • Follow the medications, diet, and exercise in your treatment plan.
  2. Keep your blood pressure controlled

    Again, follow your treatment plan carefully to control your blood pressure. The blood pressure pills usually preferred for people with CKD are called angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). These pills help protect your heart. Also, prevent fluid build-up by following your fluid and sodium (salt) limits. This will help avoid your blood pressure from rising.

    If you’re checking your own blood pressure at home, keep a record and show it to your doctor at each visit. Make sure to ask your doctor what can be done to improve them.

  3. Reduce high cholesterol levels

    High blood levels of fats, like cholesterol, increase your chances of developing heart and blood vessel problems. You will have blood tests to check your total cholesterol and other fats in your blood. If your levels are too high, you may need to follow a low-fat diet and exercise more. Some patients may also need to take pills (such as a statin) to help lower cholesterol.

  4. Treat anaemia

    CKD patients often develop anaemia or low red blood cell count. This makes you feel tired and can lead to a heart problem called left ventricular hypertrophy, the thickening of the muscle on the left side of the heart. Anaemia can be treated with a hormone called erythropoietin (EPO) and extra iron. Correcting anaemia will significantly help in keeping your heart healthy.

  5. Keep important minerals such as calcium and phosphorus in balance

    These important minerals get out of balance when you have CKD. As a result, bones lose calcium and weaken over time. Some calcium may end up in parts of your body where it does not belong, like your heart and blood vessels. This makes your blood vessels stiffer and narrower. When this happens, you are more likely to have a heart attack or stroke.

    Here’s what you need to need do:

    • Follow low-phosphorus diet
    • Take phosphate binders
    • Take an active form of vitamin D if your doctor tells you to.
  6. Stop smoking if you are a smoker

    Smoking increases your risks to develop heart and blood vessel diseases.

  7. Increase physical activity

    Please ask your doctor for an exercise program that is right for you. Regular exercise helps you:

    • Lower high cholesterol levels
    • Control blood sugar levels if you have diabetes
    • Reduce high blood pressure
    • Lose excess weight
    • Improve the fitness of your heart and lungs
    • Increase your energy level
    • Improve emotional well-being.
  8. Maintain your emotional well-being

    At times, dialysis patients may feel depressed, angry, or upset. These feelings can make it harder for you to follow your treatment plan, improve your health, and return to your normal routine. They may also increase your chance of developing heart disease.

  9. Carry out tests for heart and blood vessel disease
    • An electrocardiogram (ECG) when you first start dialysis and then once a year after that.
    • An echocardiogram when you first start dialysis.
    • Regular Blood test for Cholesterol

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