Hypertension

Hypertenion is one of the top 3 diseases I see on a daily basis. The average American with HTN (hypertension) is on 3.2 different classes of Htn medication to maintain adequate control.

Overall, the physiology of blood pressure is simply a matter of physics.

It's a closed hydraulic system! Think brakes on cars.

You have a pump. It pumps fluid (blood) into tubes of varying sizes and it returns.

There are 4 ways to control pressure in a closed hydralic system:

1) Change the speed of the pump. This effects the amount of fluid pumped per minute.

2) Change the volume of the pump. (same effect as above)

3) Change the amount of fluid in the system. More fluid, higher pressure, less fluid, lower pressure.

4) Change the volume of the system. The greater the volume, the lower the pressure, the smaller the volume, the higher the pressure..........given the other 3 variables are not changed.

Looking at the various classes of blood pressure, or "anti-hypertensives".

Alpha blockers: dialates blood vessels.....increasing system volume.......decreasing pressure.

ACE inhibitors: These work on the Renin-Angiotension system by preventing the conversion of Renin into Angiotensin II......This critter is the most powerfull vasoconstrictor known to man. Smaller blood vessals equals higher pressure......and sometimes an annoying, dry hacky cough....not fatal, but obnoxious!

ARBS (angiotensin receptor blocker): Blocks the uptake point in the angiotension I receptors to prevent vasoconstriction. Overall, I have had better luck with ACE inhibitors than ARB's in controlling HTN. Theoretically, ARB's should be more beneficial than ACEI's due to the benefits of another receptor called the "angiotensin II receptor" (not to be confused with angiotensin II), but we don't really know what this guy does yet.

Beta-blockers: Slows heart rate and contraction strength.......decreasing fluid pumped per minute......also dilates blood vessels......increasing system volume.............decreasing blood pressure.

Calcium Channel Blockers: Dilates blood vessels.....slows heart rate (but not as much as BB)

Diuretics: (the water pill)......decreases fluid in the system......decreasing blood pressure.

Blood pressure is a silent killer, resulting in strokes and end organ damage.....as a whole, hypertension and diabetes are the 2 worse diseases for kidney health.

Salt acts to retain fluid, thereby increasing the blood pressure (and causing the dreaded CANKLES!!!)

This is totally unnecessary as man has not needed salt since the invention of the refrigerator!!!!

There you have it, blood pressure in a nutshell, along with the basic arsonal of medications to help control it. Meds alone are not enough however!!! Blood pressure is impossible to control without addressing the other elements of metabolic syndrome, which include cholesterol levels, abdominal girth, diabetes along with a persons diet, activity level and overall fitness.