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A recent breakthrough from the University of Virginia School of Medicine reveals how commonly prescribed blood pressure medications, known as renin-angiotensin system (RAS) inhibitors, can contribute to kidney damage over time. The research, published in Circulation Research, details how these drugs trigger cellular changes that impair the kidneys’ ability to filter blood. While these medications are highly effective in controlling high blood pressure and reducing cardiovascular risk, the findings highlight potential long-term safety concerns that warrant further investigation.
What’s New: How RAS Inhibitors Affect the Kidneys
Researchers discovered that RAS inhibitors inadvertently cause the kidneys to reprogram themselves. The medications stimulate overproduction of the hormone renin, promote excessive nerve growth, and enlarge cells lining the tiny blood vessels in the kidneys. Over time, these changes lead to scarring, inflammation, and structural damage. The study describes this process as a “serious but gradual” vascular condition that renders the kidneys incapable of fulfilling their role in filtering blood. Conducted in rodents, the research underscores the need for human trials to confirm these findings.
Why It Matters: Balancing Benefits and Risks
High blood pressure affects nearly half of adults in the United States—approximately 120 million people—according to the CDC. RAS inhibitors are widely used as a first-line treatment for hypertension due to their effectiveness in preventing heart attacks, strokes, and other vascular diseases. However, this research raises important questions about their long-term impact on kidney health. Medical experts caution that patients should not discontinue these medications without consulting their healthcare providers, as they remain a cornerstone of hypertension management. These findings pave the way for strategies to mitigate kidney damage without compromising the drugs’ cardiovascular benefits.
Looking Ahead: Toward Safer Hypertension Treatment
The UVA research team hopes this discovery will lead to the development of safer treatments. “We need to accurately understand the effects of long-term use of RAS inhibitors on the kidneys,” said Dr. R. Ariel Gomez, one of the study’s authors. Researchers plan to explore ways to counteract the kidney-damaging effects while preserving the efficacy of these critical medications. According to Dr. Maria Luisa S. Sequeira-Lopez, another researcher, these findings “may open new avenues for the prevention of adverse effects when treating hypertension.”
By addressing the root cause of kidney damage, future therapies could offer a safer path for the millions of people who rely on RAS inhibitors to manage high blood pressure.