After my last checkup my G.P. reduced by B.P. meds substantially after a reading of 120/60 which he felt was too low. Since that time it is hovering around 140/60 and frequently higher. Given that I am suffering from Stage 4 CKD disease, wouldn’t maintaining as low as possible B.P. be the highest priority. I am 85 years old so what would be the ideal B.P. level to aim for?Also among the different drugs used to lower B.P., which would you consider the safest for people suffering from kidney disease?

The optimum blood pressure that I strive for is less than 130/80 for blood pressure control but I do not seek a blood pressure lower than 110 systolic.  I would also strive to avoid any symptoms of light-headedness or weakness that might be the result of having a lower blood pressure.  I am unable to recommend blood pressure medications without performing a complete history and physical examination.  Most blood pressure medications can be used with caution and careful monitoring in patients with chronic kidney disease (CKD).  I suggest that you express your concerns to your physician.

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