What is the relationship between hypertension and proteinuria?

Proteinuria is a term that describes the presence of abnormal levels of protein in the urine. High blood pressure, or hypertension, is a medical condition that increases the risk of stroke, heart attack, and other cardiac events. Hypertension and proteinuria are related because proteinuria can be a sign of hypertension.

Healthy urine usually contains only small amounts of protein, because the kidneys filter waste, including protein, from the blood as it circulates through the organs. The wastes that are filtered by the kidneys are excreted in the urine, but the proteins are too large to pass through the filtering units of the organs and are not excreted. However, if the kidneys are damaged, protein can pass into the urine. The most common protein found in urine is albumin, a blood protein that helps regulate fluid levels in the body.

Kidney damage leading to proteinuria is most often caused by inflammation due to infection, kidney disease, hypertension, and diabetes. Most people with mild hypertension and proteinuria do not have any symptoms, as symptoms are not obvious unless there are large amounts of protein in the urine. Consequently, people with hypertension and proteinuria are at risk for kidney damage that cannot be repaired.

When signs of proteinuria appear, the most common is the appearance of urine; when large amounts of protein are present in the urine, it appears foamy. Another common sign of proteinuria is swelling of the feet, hands, abdomen, or face. This swelling develops due to the loss of fluid-regulating albumin from the blood.

The relationship between hypertension and proteinuria, and the effect high blood pressure has on the kidneys, makes it even more important that the disease be diagnosed early. Therefore, someone with known high blood pressure might have a urine test to determine if there are abnormal levels of protein in her urine. If proteinuria is detected, the person may undergo further testing to determine the extent of kidney damage.

When a person is diagnosed with hypertension and proteinuria, the main goal of treatment is to control high blood pressure. This will help reduce the risk of further kidney damage, as well as the risk of heart attack and other serious complications. The most common medications prescribed are angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), because these medications can help protect the kidneys from further damage.

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