Sudden High Blood Pressure and Kidney Hydronephrosis

Sudden onset of elevated blood pressure and hydronephrosis?

Hello Doctor: I am 31 years old and have a regular habit of donating blood.
My blood pressure has never exceeded the normal range until mid-April this year when my company conducted a health check, and my blood pressure was measured at 144.
Since that day, I have been measuring my blood pressure at home every day.
The readings have sometimes been as low as 110, but mostly they range from the 120s to the 150s, and the first measurement is always higher.
When I measure again after an interval of about 1 to 2 minutes, it usually falls in the 130s.
I feel increasingly anxious about the sudden rise in my blood pressure; I find myself constantly researching blood pressure during the day, and I feel the urge to measure my blood pressure every morning upon waking and every night before sleeping.
I would like to know if this anxiety could be affecting my blood pressure.
Should I continue measuring it, or should I take a break for a while? Additionally, during the health check, an ultrasound revealed that I have hydronephrosis, and I also have a uterine fibroid about 10 centimeters in size.
The health check personnel mentioned that it might be compressing the ureter.
They suggested that I see a gynecologist.
Could this issue be causing my high blood pressure? However, the fibroid and hydronephrosis have not caused me any discomfort, and I have no abnormalities in urination or abdominal pain, etc.
If it weren't for the health check, I wouldn't have discovered these two issues.
I have a long-standing habit of staying up late, and since discovering my elevated blood pressure, I have been trying to adjust my schedule.
However, it seems that I have not seen any results yet.

Btp, 30~39 year old female. Ask Date: 2021/05/06

Dr. Wu Jiyu reply Internal Medicine

First, let's define what hypertension is.
If you only have hypertension, your target is to maintain blood pressure below 140/90 mmHg.
However, if you have comorbidities such as chronic kidney disease or diabetes, the target should be below 130/80 mmHg.
Based on your current condition, a target of less than 140/90 mmHg is appropriate.
The key to maintaining good health lies in adopting healthy lifestyle habits, such as getting adequate sleep, exercising regularly, maintaining a healthy weight, and reducing salt intake.
Regarding hydronephrosis, it is advisable to consult a urologist for follow-up to clarify your condition (it should not affect blood pressure unless it is left untreated for a long time, which could impact kidney function).
Thank you for your inquiry; the Nephrology Department of Changhua Hospital cares about your health.

Reply Date: 2021/05/06

More Info

Sudden high blood pressure can be concerning, especially when it appears unexpectedly after a history of normal readings. In your case, the increase in blood pressure to levels between 120-150 mmHg, especially with a reading of 144 mmHg during a health check, is noteworthy. It’s understandable that this sudden change has caused you anxiety, which can further exacerbate the situation.
Firstly, it’s important to recognize that anxiety can indeed influence blood pressure readings. When you are anxious, your body releases stress hormones like adrenaline, which can lead to temporary spikes in blood pressure. This is often referred to as "white coat syndrome," where patients experience elevated blood pressure in clinical settings due to anxiety. Therefore, your feelings of anxiety about your blood pressure could be contributing to the higher readings you are observing.
Regarding your question about whether to continue monitoring your blood pressure, it may be beneficial to take a balanced approach. Regular monitoring can help you understand your blood pressure patterns, but if it is causing you significant anxiety, consider taking a break from daily measurements. Instead, you might measure your blood pressure a few times a week and focus on maintaining a healthy lifestyle, which can help reduce both your blood pressure and anxiety levels.

Now, concerning the hydronephrosis you mentioned, which is the swelling of a kidney due to a build-up of urine, it can indeed be related to your blood pressure. Hydronephrosis can occur when there is an obstruction in the urinary tract, such as from a large uterine fibroid pressing on the ureters, which may lead to increased pressure in the kidneys. This condition can potentially affect kidney function and, in some cases, lead to secondary hypertension. However, if you are not experiencing any symptoms such as pain, changes in urination, or abdominal discomfort, it may not be the primary cause of your elevated blood pressure.

It is advisable to follow up with a healthcare provider, particularly a urologist or nephrologist, to evaluate the hydronephrosis and determine if any intervention is necessary. They can assess whether the hydronephrosis is significant enough to warrant treatment or if it is something that can be monitored over time. Additionally, consulting with a gynecologist regarding the uterine fibroid may also be beneficial, especially if it is causing any pressure symptoms.

In the meantime, lifestyle modifications can play a crucial role in managing your blood pressure. Here are some strategies you can consider:
1. Diet: Adopt a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruits, vegetables, whole grains, and lean proteins while reducing sodium intake.

2. Exercise: Regular physical activity can help lower blood pressure. Aim for at least 150 minutes of moderate-intensity exercise each week, such as brisk walking.

3. Sleep: Prioritize good sleep hygiene. Aim for 7-9 hours of quality sleep each night, as poor sleep can contribute to hypertension.

4. Stress Management: Engage in relaxation techniques such as deep breathing, meditation, or yoga to help manage anxiety and stress levels.

5. Regular Check-ups: Continue to have regular check-ups with your healthcare provider to monitor your blood pressure and kidney health.

In summary, while your anxiety may be contributing to your elevated blood pressure, it is essential to investigate the hydronephrosis and any potential underlying causes. By addressing both your physical health and mental well-being, you can work towards achieving better blood pressure control and overall health.

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