Heart Disease Could Be Harming Your Kidneys Too: New Guidelines Urge These Tests

Heart disease may not be a problem that stops at the heart. New guidelines from the European Society of Cardiology (ESC), developed with the European Renal Association (ERA), are urging doctors to pay much closer attention to kidney health in people with cardiovascular disease.

The recommendations, published in the European Heart Journal and presented at ESC Congress 2026, are the first ESC guidelines specifically dedicated to managing cardiovascular disease (CVD) alongside chronic kidney disease (CKD). Their message is straightforward: heart and kidney health are closely connected, and identifying kidney problems early could help reduce complications affecting both organs.

How Are The Heart And Kidneys Connected?

The relationship works in both directions. CKD can increase a person's risk of developing cardiovascular disease, while cardiovascular problems can also contribute to worsening kidney function. The two conditions can therefore create a damaging cycle, potentially increasing the risk of cardiovascular events and, in advanced cases, kidney failure requiring dialysis.

The ESC estimates that around 100 million people in Europe are living with CKD. Importantly, CKD is not simply defined by having one abnormal kidney test. It involves abnormalities in kidney structure or function that persist for at least three months and have implications for health. The new guidelines are designed to make sure kidney disease is not missed when someone is being treated for a heart condition.

Two Tests Doctors Want Heart Patients To Have

One of the biggest recommendations is screening for CKD in people with cardiovascular disease using both blood and urine tests. The first is the estimated glomerular filtration rate (eGFR), which is calculated using blood creatinine levels and provides an estimate of how well the kidneys are filtering blood. The second is the urine albumin-to-creatinine ratio (UACR). It looks for albumin, a protein that can leak into urine when the kidneys are damaged.

The ESC recommends these measurements for people with a range of cardiovascular conditions, including hypertension, coronary artery disease, heart failure, peripheral artery disease and stroke. To establish that kidney abnormalities are chronic, rather than temporary, two measurements of eGFR and UACR over at least three months are recommended.

What Happens If Kidney Disease Is Detected?

The guidelines use a framework called “STAMP on CKD” — Screen, Triage, Address CKD Risk, Modify CVD management and Plan health services.

That means screening is only the first step. Doctors are also encouraged to assess a person's risk of kidney failure and cardiovascular complications, identify appropriate treatments early and adjust cardiovascular care when reduced kidney function affects the safety or effectiveness of certain medicines or procedures.

The recommendations highlight several established treatments. RAS inhibitors, which include ACE inhibitors and angiotensin receptor blockers, and SGLT2 inhibitors are recommended for many patients with CKD because they can reduce the risk of kidney disease progression and cardiovascular complications. Statin-based treatment also remains important where appropriate.

For people who have CKD, type 2 diabetes and albuminuria, the guidelines also recommend considering treatments such as the non-steroidal mineralocorticoid receptor antagonist finerenone and GLP-1 receptor agonists such as semaglutide to reduce kidney and cardiovascular risks. These medicines are not appropriate for everyone and should be prescribed according to an individual's condition and medical history.

What Does This Mean For Patients?

The new guidance does not mean that everyone with heart disease has kidney disease. Instead, it highlights why the two organs should not be assessed in isolation. For someone already diagnosed with cardiovascular disease, a routine conversation with their doctor about kidney function could be important. A blood test and urine test may reveal kidney abnormalities that have not yet caused obvious symptoms, allowing doctors to assess risk and decide whether treatment needs to change.

The broader message from the guidelines is that protecting the heart can also mean paying attention to the kidneys, and protecting the kidneys can help protect the heart. Earlier detection, appropriate treatment and closer coordination between cardiologists, kidney specialists and other healthcare professionals could help break the cycle between the two conditions.

 

 

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Why people with Type 1 diabetes have a greater risk for heart diseases; preventive measures

Cardiovascular events are becoming more common, occuring at a younger age than usual - equally both in males and females. But people with Type 1 diabetes mellitus (T1DM) have a higher risk of developing heart disease than the general population, although the reason behind this hasn’t been clearly understood. In fact, people with both types of diabetes - Type 1 and Type 2 - have a higher risk for heart disease, perhaps, just for different reasons.

The Pittsburgh Epidemiology of Diabetes Complications (EDC) study showed that the incidence of major coronary artery disease (CAD) events in young adults (aged 28-38 years) with Type 1 diabetes mellitus was 0.98 per cent per and surpassed 3 per cent per year after age 55 years, making it the leading cause of death in that population. Patients with Type 1 diabetes can prevent or reduce their risk of developing an immune reaction to their own body, one that specifically attacks the heart, by keeping their condition under control through a combination of medication and lifestyle changes.
The link between CVD and Type 1 diabetes

The main risk factors responsible for cardiovascular disease in Type 1 diabetes are hypertension, cigarette smoking, obesity, lipid levels, inflammation, microalbuminuria, and poor glycemic control. According to Dr M Sai Sudhakar, Director - Cath lab, Chief Interventional Cardiologist and Chief Cardiac Transplant Physician at Gleneagles Global Hospitals, Lakdi ka Pul, Hyderabad, there are several potential explanations why patients with Type 1 diabetes have a greater risk for CVD. A scientific statement from the American Heart Association and American Diabetes Association explained how type 1 diabetes mellitus increases your risk for CVD. Here's how:
 
Genetic polymorphisms appear to influence the progression and prognosis of CVD in Type 1 diabetes mellitus.
 
People exposed to higher blood sugar levels were more likely to develop an autoimmune response to the heart proteins linked to later development of heart disease, including heart attack and death.
 
Abnormal vascular findings associated with atherosclerosis are seen in patients with T1DM. 

Endothelial function alters even at a very early stage of type 1 diabetes mellitus. Atherosclerosis - When plaque clogs your arteries - in the setting of Type 1 diabetes mellitus is characterised by more severe stenoses, more extensive multiple vessels and more distal coronary findings than in patients without the disease.
 
Neuropathy in Type 1 diabetes mellitus can cause abnormalities in the response of coronary vasculature to sympathetic stimulation, which may manifest as resting tachycardia or bradycardia, exercise intolerance, orthostatic hypotension, loss of the nocturnal decline in BP, or silent myocardial ischemia on cardiac testing. These abnormalities can result in delayed presentation of CVD.
 
Inflammation operates in T1DM via multiple mechanisms, which may include hyperglycemia and hypoglycemia, excess adiposity or altered body fat distribution, thrombosis, and adipokines.

Prevention

The good news is, there are many things you can do to reduce your risk of developing heart disease or having a heart attack. These include:

Risk modifications such as avoidance of smoking, maintenance of a normal weight, and consumption of a balanced diet replete in fruits and vegetables and enriched in whole grains, but low in saturated fat and sodium are generally recommended.
 
Aggressive diabetes and lipid management is of utmost importance. A lower BP goal of <130 appropriate="" be="" br="" in="" individuals.="" may="" mmhg="" younger=""> 
All patients with Type 1 diabetes mellitus and hypertension or albuminuria are usually advised to take an angiotensin-converting enzyme (ACE) inhibitor -- a class of medication used to treat certain heart and kidney conditions. If an ACE inhibitor is not tolerated, an angiotensin II receptor blocker (ARB) may have similar efficacy.
 
People suffering from diabetes are vulnerable to heart ailments, which may trigger a stroke unless the patient adopts a healthy lifestyle. It is essential for diabetic patients to maintain their cholesterol level at the prescribed limit, regular physical activity, and reduce their body weight in addition to taking the right medication.

Following the right preventive methods and appropriate treatment may help reduce the risk of heart complications and improve the life expectancy in patients with diabetes.

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Grana Padano: The Hard Cheese Good Health Story

Cheese is certainly delicious, but you might be surprised to learn that eating it regularly can also be beneficial to your health. Recent research seems to suggest that there is, at least, one Italian cheese that can protect your heart. What great news this is for us cheese lovers!

 

The study showed that people with high blood pressure saw their systolic blood pressure improve by 7 to 8 millimeters of mercury (mm Hg) and their diastolic blood pressure by 5 to 7 mm Hg, after they had eaten a single ounce of the renowned Italian cheese Grana Padano per day for two months.

The people in the study who did not eat the semi-fat hard, parmesan-like cheese, but rather a fake-dairy version of it, saw no improvement in their blood pressure.

Lead study author found that Grana Padano contains two compounds that can relax your blood vessels, leading to a lowering of your blood pressure. These are known as isoleucine-proline-proline (IPP) and valine-proline-proline (VPP).

IPP and VPP function like common blood pressure ACE inhibitors (e.g. Lotensin or Capoten), which stop our bodies producing angiotensin II, an active hormone that increases blood pressure by constricting blood vessels.

Although this study is exciting, both for the health news and for the excuse to eat cheese, Dr. sounds a note of caution. He says that because cheeses contain lots of salt and fat, they can really boost your calorie count if you’re not careful. For this reason, he recommends substituting an ounce of Grana Padano cheese for every dairy serving you normally eat per day.

It's not clear at this stage whether similar cheeses, such as the similar Parmigiano Reggiano, offer the same health benefits. Yet, future studies are likely to be started to explore and resolve the question.

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Checking a Cough is Essential

Most people assume that coughing is associated with a lung or an airway problem. But, an unusual suspect may actually be the heart. It isn't unusual for people who have heart failure to experience significant coughing. In fact, a cough may indicate an important sign that heart failure treatment is inadequate, or, possibly, treatment may be causing problems. 

1. Heart Failure
Heart failure does not mean that the heart just stops, that is cardiac arrest. Rather, it means that the heart's pumping ability has been impaired to the extent that the heart is not always able to keep up with the demands of the body. Heart failure can cause a number of cardiac disorders, including coronary artery disease, hypertension, hypertrophic cardiomyopathy, diastolic dysfunction, and heart valve disease, among several others. Heart failure is a common disorder, with over a million people each year being hospitalized in the world.
A common problem with heart failure is that due to the heart's inefficient pumping ability, blood returning to the heart from the lungs tends to back up, producing pulmonary congestion, which is why people with heart failure are often said to have 'congestive heart failure.'
Consequently, with pulmonary congestion, fluid, and a little blood, can leak into the alveoli (air sacs) of the lungs. This lung fluid is what's largely responsible for the dyspnea (a feeling one cannot breathe properly) commonly experienced by people with heart failure because coughing is the body's way of clearing the airway and bronchial passages. Thus, it makes sense that a cough can also result from pulmonary congestion. 
2. Cardiac Cough
Coughing caused solely by heart failure can take several forms. A wet cough produces frothy sputum that may be tinged pink with blood, tends to be quite common with heart failure. Heavy wheezing and labored breathing may also accompany spells of coughing, along with a bubbling feeling in the chest, or even a whistling sound from the lungs.
Coughing symptoms like this usually are a sign that heart failure has become substantially worse, and such a cough is usually accompanied by a general flare-up of heart failure symptoms. These symptoms are likely to include dyspnea, orthopnea (shortness of breath when lying down), edema (swelling), and paroxysmal nocturnal dyspnea - waking up from sleep in the middle of the night, gasping and coughing. However, people who have this severe form of cardiac cough are generally sick enough to seek medical help without much prompting. 
A cardiac cough can take a much less severe form. Some people with heart failure will develop an annoying, more chronic, drier cough that may produce a small amount of white or pink frothy mucus. People who have this less severe form may assume it to be due to some other cause, and thus may fail to seek medical assistance. In doing so, however, the symptoms of heart failure are likely to become substantially worse. So anyone who has been told they have heart failure should not ignore the onset of a cough even if they consider it to be mild. 

3. Medication-Related Cough
Coughing is also a common effect of a class of medication that is often prescribed to those who have been diagnosed with heart failure: angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are helpful for heart failure because they dilate the arteries, thus making it easier for the heart to pump blood. These drugs, however, produce a cough in about 4% of people who do take them.
The cough they experience is generally a dry hacking cough which does not produce sputum. Reports suggest that non-steroidal anti-inflammatory drugs (NSAIDs) may improve a cough caused by ACE inhibitors, but, in the large majority of people who have this problem, the drug must be discontinued, primarily because the ACE inhibitor can be switched to an angiotensin II receptor blocker (ARB), which has many of the same advantages as the ACE inhibitor, but which causes coughing less frequently. A change in medication can help relieve a dry, hacking cough due to ACE inhibitors.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                
 PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/                                                                                                                                                                             FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-                                               
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