Long-term treatment of high blood pressure using renin–angiotensin system (RAS) inhibitors may lead to kidney damage in some patients, according to a discovery by University of Virginia (UVA) School of Medicine researchers published in November 2024. While these drugs are widely used as first-line hypertension treatments, researchers found they can cause scarring that impairs the kidney’s ability to filter blood.
How RAS Inhibitors Affect Kidney Function
Renin–angiotensin system (RAS) inhibitors are a class of medications designed to block the effects of the renin enzyme. By doing so, they relax blood vessels, which allows blood to flow more easily. While this process is effective for managing hypertension—a condition affecting more than 1.3 billion people globally—it can have unintended consequences for the kidneys over time.
According to researchers at the UVA School of Medicine, long-term use of these drugs can cause the kidney to undergo physical changes, such as scarring. These changes shift the primary function of the organ from filtering and purifying blood to producing renin. When this occurs, the kidney can no longer effectively clear impurities from the blood, leading the researchers to describe the organ as a “pathological neuro-immune endocrine organ.”
Why This Discovery Matters for Patients
The findings, reported on November 18, 2024, highlight a potential trade-off in the long-term management of high blood pressure. R. Ariel Gomez, MD, of UVA’s Child Health Research Center, noted that while these medications are widely considered safe and are commonly prescribed, the evidence suggests they may be damaging the kidneys in some individuals.
This research does not suggest that patients should immediately stop their prescribed blood pressure treatments. Instead, the discovery is intended to help medical professionals better understand the impact of long-term RAS inhibitor use. The goal is to develop improved strategies for managing hypertension and other vascular diseases while protecting kidney health.
Understanding Hypertension Risks
High blood pressure remains a significant global health concern, forcing the heart to work harder than necessary. If left unmanaged, hypertension is a known risk factor for several serious medical conditions, including:
- Stroke
- Myocardial infarction (heart attack)
- Vision loss
- Kidney damage
Because these risks are severe, the current medical consensus emphasizes the importance of managing blood pressure. The recent UVA study provides new insight into how the medications used to achieve this goal interact with the kidneys, potentially opening the door to more precise, kidney-protective treatment plans in the future.
Frequently Asked Questions
Are RAS inhibitors still considered safe?
They are widely used as first-line medications for hypertension. However, the recent UVA research suggests that long-term use can cause kidney damage in some patients, highlighting the need for continued monitoring.
What happens to the kidney during long-term use of these drugs?
According to the UVA researchers, the kidney may develop scarring and physical changes that shift its focus away from blood filtration toward the production of renin.
Should I stop taking my blood pressure medication?
No. Patients should consult their healthcare provider before making any changes to their prescribed medication regimen. The researchers emphasize that the goal of their work is to identify better ways to treat hypertension while protecting the kidneys.