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Why do patients with lupus have high blood pressure?

Most patients with lupus do not have high blood pressure. If hypertension or an elevated blood pressure is identified in a patient with lupus it may be a coincidence and represent the co-occurrence of both lupus and what is known as essential hypertension. In this scenario there is often a history of high blood pressure in other blood relatives. High dose steroids are occasionally complicated by a rise in blood pressure and this risks is greatest when very high doses, especially administered in intravenous rather than oral forms, are given. Finally, perhaps the most serious circumstance occurs when a patient with lupus has significant kidney involvement, either inflammation or scarring, as this can be associated with high blood pressure. It is essential to control the blood pressure in this situation as failure to do so can contribute to further kidney damage. Classes of medication for blood pressure that may be especially helpful in this setting are ACEI, angiotensin converting enzyme inhibitors, and ARB, angiotensin receptor blockers.

Many patients with lupus do not have high blood pressure. However, it can often occur as a side effect of steroid treatment for the disease.

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