Fibromuscular dysplasia: A cause of high blood pressure?

In fibromuscular dysplasia, the muscle and fibrous tissues in arteries thicken and harden into rings — which restricts blood flow through the affected arteries and to the organs supplied by these arteries. When fibromuscular dysplasia involves the renal arteries, blood flow to the kidneys is impaired. This triggers the kidneys to release excessive amounts of the enzyme renin, which increases your blood pressure.

The cause of fibromuscular dysplasia isn't known. But you are at increased risk if you smoke or have a family history of this condition.

In mild cases, high blood pressure caused by fibromuscular dysplasia may be treated with diet, exercise and medication while your doctor periodically monitors your kidney function.

In more severe cases, treatment may include:

• Opening the clogged arteries with angioplasty (percutaneous angioplasty) and possibly placing wire mesh tubes (stents) within the arteries to keep them open
• Surgery to reroute blood flow around the affected arteries

If the renal arteries can be unblocked and blood flow to the kidneys improved, blood pressure usually returns to normal.

• If you feel full after eating only a small amount, try eating small amounts more frequently when you do get the urge to eat. You may find it easier to eat small amounts several times each day rather than at mealtimes.
• If you never seem to feel hungry, it's often helpful to eat according to a schedule rather than to rely on appetite.
• Take advantage of the times when you feel your best. Eat more when you're hungry. Many people have their best appetite in the morning, when they're rested.
• Limit fluids during meals, as liquids can fill you up and limit your intake of higher calorie foods. It may help to drink most of your liquids 30 to 60 minutes before or after meals.
• Create a pleasant mealtime atmosphere. For example, use soft music, candles or nice place settings.
• Vary the color and texture of foods to make the meal more appealing.
• For adults, a small amount of wine or beer before meals — if allowed by your doctor — may stimulate your appetite.
• Pay attention to smells, as certain scents may decrease your appetite or bring on nausea. Avoid smells that have this effect on you.

• Cold or room temperature foods may be more appealing, particularly if strong smells bother you. Cold sandwiches or main-dish salads, such as tuna, chicken, egg and ham salads, are good choices.
• Experiment with foods. Once-favorite foods may no longer appeal to you, while foods you were never fond of may become appealing.
• Regular moderate exercise may help stimulate your appetite. Check with your doctor for exercise limits.
• Nutritional supplement drinks, such as canned or powdered shakes, can provide a significant amount of calories and require little or no preparation. It may be easier for you to drink rather than to eat something.

Protein is important for growth, health and repair of your body. If you've been ill, you may need extra protein. Some suggestions include:

• Add extra meat, poultry, fish or beans (pinto, navy, black, kidney) to casseroles, soups or stews.
• Make your own high-protein milk: Add 1/4 cup (59 milliliters) powdered milk to 1 cup (237 milliliters) whole milk, or 1 cup (237 milliliters) powdered milk to 1 quart (about 1 liter) whole milk. Use it as a beverage, add it to malts or shakes, or use it in cooking.
• Try a commercially prepared protein supplement.

If illness has made red meat — beef, pork or lamb — less appealing to you, try the following foods, which also are good sources of protein:

• Cheese
• Cottage cheese
• Beans
• Lentils
• Eggs
• Fish
• Poultry
• Nuts
• Peanut butter
• Milk
• Milkshakes
• Custard
• Pudding
• Yogurt

If your loss of appetite is keeping you from eating well for more than a few days, you might consider taking a multivitamin to help you get the vitamins and minerals you need. Check the label and look for a multivitamin that doesn't give you more than 100 percent of the Daily Value (DV) of all the vitamins and minerals. Keep in mind, though, that if you're drinking liquid nutritional supplements, those will give you some of the vitamins and minerals you need, so you may not need a multivitamin. A nutritional supplement drink usually contains the equivalent of about one-fourth of a multivitamin.