The prevalence of hypertension has been on the rise which causes a large global economic burden worldwide. Hypertension is a major independent risk factor for cardiovascular events, cerebra-vascular events and renal disease. Hypertension-induced kidney damage is associated with increased cardiovascular morbidity and mortality. The coexistence of hypertension and obesity, hyper-lipidemia or diabetes results in worse renal dysfunction than isolated occurrence of either risk factor alone. Evidence from numerous clinical trials has demonstrated benefits of blood pressure (BP) control.
The target of 140/90mmHg that has been established from observational data remains fully justifiable. However, it is unclear whether the available results could be extrapolated to elderly patients. It is unknown whether the target of 140/90mmHg is most optimal goal to protect elderly renal function. It is debatable about the BP targets when hypertension in the elderly is complicated by coexist with obesity, hyper-lipidemia or diabetes. The lower target limit of BP for hypertension treatment is still not determined. On the other hand, Intensive hypertension treatment probably causes hypotension in elderly patients which is also an independent predictor of cardiovascular disease and of all-cause mortality. Usually hypotension including orthostatic and postprandial hypotension is neglected among elderly.
A blood pressure reading is given in millimeters of mercury (mm Hg). It has two numbers.
• Top number (systolic pressure). The first, or upper, number measures the pressure in your arteries when your heart beats.
• Bottom number (diastolic pressure). The second, or lower, number measures the pressure in your arteries between beats.
HIGH BLOOD PRESSURE
Blood pressure is the force of your blood against the walls of your blood vessels as your heart pumps blood around your body. If this pressure becomes too high, you are said to have high blood pressure, or hypertension.
The only way to tell if your blood pressure is too high is to have it measured. High blood pressure usually causes no symptoms. That is why it has been called a “silent killer.” A single high reading may not mean you have high blood pressure. It should be confirmed on follow-up visits to your doctor or clinic. Blood pressure is measured as two numbers. The top number, or systolic blood pressure, is the pressure when your heart is beating. The bottom number, or diastolic blood pressure, is the pressure when your heart is resting between beats. A blood pressure reading of 130/80 is read as 130 over 80.

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Normal blood pressure in adults 18 and older is less than 120/80. People, who have blood pressure between 120 and 139 for the top number, or between 80 and 89 for the bottom number, may be more likely to develop high blood pressure unless they take steps to prevent it. In general, blood pressure that stays at 140/90 or higher is considered high. However, for people who have diabetes or Kidney Disease, a blood pressure of 130/80 or higher is considered high.
Blood pressure is usually checked by using a blood pressure cuff around your arm. It should be checked every time you visit your doctor or clinic. You may also be taught to check your own blood pressure at home. Keep a record of your daily blood pressure and show this to your doctor at each visit.
CAUSES OF HIGH BLOOD PRESSURE
Occasionally, high blood pressure is caused by an underlying medical illness. In these cases, treatment of the underlying medical condition may lower the blood pressure. However, the vast majority of people with hypertension have what is called essential hypertension or primary hypertension. This means that their elevated blood pressure is not related to any underlying medical condition. This type of blood pressure cannot be cured, but it can usually be adequately controlled with medication and/or lifestyle changes.
Some causes of high blood pressure are Foods, medicine, lifestyle, age, and genetics. Common factors that can lead to high blood pressure include:
• A diet high in salt, fat, and/or cholesterol.
• Chronic conditions such as kidney and hormone problems, diabetes, and high cholesterol.
• Family history, especially if your parents or other close relatives have high blood pressure.
• Lack of physical activity.
• Older age (the older you are, the more likely you are to have high blood pressure).
• Being overweight or obese.
• Race (non-Hispanic black people are more likely to have high blood pressure than people of other races).
• Some birth control medicines and other medicines.
• Stress.
• Tobacco use or drinking too much alcohol.
COMPLICATIONS OF HIGH BLOOD PRESSURE
The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels as well as your organs. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to complications including:
• Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
• Aneurysm. Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
• Heart failure. To pump blood against the higher pressure in your vessels, the heart has to work harder. This causes the walls of the heart's pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.
• Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally.
• Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
• Metabolic syndrome. This syndrome is a group of disorders of your body's metabolism, including increased waist size, high triglycerides, decreased high-density lipoprotein (HDL) cholesterol (the "good" cholesterol), high blood pressure and high insulin levels. These conditions make you more likely to develop diabetes, heart disease and stroke.
• Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people with high blood pressure.
• Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading to a certain type of dementia (vascular dementia). A stroke that interrupts blood flow to the brain also can cause vascular dementia.
HIGH BLOOD PRESSURE AND KIDNEY FUNCTION
Over time, high blood pressure can damage blood vessels throughout your body. This can reduce the blood supply to important organs like the kidneys. High blood pressure also damages the tiny filtering units in your kidneys. As a result, the kidneys may stop removing wastes and extra fluid from your blood.
When you have high blood pressure, the blood flows through these blood vessels with a lot of force. This can harm these blood vessels and cause kidney disease. However, high blood pressure can also be a symptom of kidney disease. Kidneys help your body control your blood pressure.
PREVENTION
Reducing hypertension prevents heart attack, stroke, and kidney damage, as well as other health problems.
• Reducing salt intake (to less than 5g daily).
• Eating more fruit and vegetables.
• Being physically active on a regular basis.
• Avoiding use of tobacco.
• Reducing alcohol consumption.
• Limiting the intake of foods high in saturated fats.
• Eliminating/reducing Trans fats in diet.
CONCLUSION
In conclusion, there is a strong relationship between hypertension and Chronic Kidney Disease (CKD). Hypertension is an important cause of End-Stage Renal Disease (ESRD), contributing to the disease itself or, most commonly, contributing to its progression. On the other hand, hypertension is highly prevalent in CKD patients, playing a role in the high cardiovascular morbidity and mortality.