Dhia Aldoori

Dhia Aldoori
Autumn 2011 in Ohio

Monday, April 21, 2008

Chapter 8: Hypertension (Abnormal Persistent Blood Pressure Elevation.)

Opinion: Controlling a disease is not an acceptable long-term goal. Only cure and prevention are. I realize I am stating the obvious but I see this forgotten in medical care all the time.

The form of hypertension I am addressing here is the common form called essential hypertension. Before now I haven't seen a convincing explanation for why it develops. The explanation the way I see it is as follows:
Blood pressure in the human body is regulated according to a fixed hierarchy designed to preserve the brain. This regulation is controlled and orchestrated by the vasomotor center situated in the medulla, which is the lowermost part of the brain in vertebrates. At the pinnacle of above-mentioned hierarchy is this vasomotor center that will control the rest of the body’s blood pressure in a normal way only so long as it is itself healthy and well. In the case of essential hypertension the health of the vasomotor center is sub optimal because the body isn't supplying a healthy blood supply (carbon monoxide and low oxygen from smoking for example), not enough healthy nutrients, too much sugar, or not enough energy hormones. Usually it is a combination of some or all of above. What ensues is that the signals to the rest of the body’s blood vessels (arteries) is to contract more thereby pushing a larger blood supply to the vasomotor center, targeting satisfaction of the vasomotor center’s requirements. Unfortunately this is done at the expense of the rest of the body’s tissues and damages them. An extreme example of this damage is a stroke whereby the arteries have become so constricted that an event occurs and the blood supply to an area of the brain (other than the vasomotor center of course), is lost. That area dies and results in different clinical syndromes of brain malfunction such as paralysis or inability to speak and so on.
Therefore we should understand essential hypertension as an unhealthy state of the body, which must be taken very seriously. Fortunately this condition is totally preventable by applying The Pillars Of Health. It is most likely reversible also by applying The Pillars. In long standing hypertension it is possible that the vasomotor center has become damaged and can't be repaired back to original normality, but I don’t think so. Future research will tell.
The Pillars Of Health will do its good deeds by elevating all the energy hormones and other substances, which will promote good health in the vasomotor center cells. This will allow this center to send out stimulating signals to maintain blood pressure in the body, which is consistent with the health of the whole body and not put the vasomotor center into a self preservation mode.
I am sure many people who have hypertension and are on medications are wondering: Then what is the use of taking all these medicines? The different medicines currently being used are good for controlling the blood pressure and overriding the signals, or their ultimate effects, coming from the vasomotor center. The advantage here is protection of the body’s tissues from damage, as in strokes. The drawback is that you are only controlling a part of the disease condition and not correcting it. We must aim at making our bodies healthy by removing the reason that the vasomotor center is sending those signals in the first place and then we won’t need said medications. If we don’t, then the body is still actually not healthy and for sure we are doing harm to the body especially at a cellular level. Additionally, using medications adds unnatural chemicals to our systems that have its side effects on the body. Also it is very costly.
There are other factors, which affect blood pressure such as emotion and stress, but they are not the major players in the long run unless they are hurting the implementation of The Pillars Of Health.
Another snippet within this context is about salt (sodium). I doubt if salt plays any significant role in evolution of essential hypertension. It is possible that it may worsen an already present unhealthy condition, but it is not the instigator.
Note to doctors - From above you can see why obese people are more prone to have essential hypertension as since the person has been taking in excess calories and resulted in the obesity therefore the body is more likely to be in a storage mode. This inherently will have the level of energy hormones (such as adrenaline, thyroxin, and cortisol) on the lower side relatively speaking to the size of the person’s body. On the other hand HMG coenzyme A reductase will be more active (because of the excess calories), and hence we will have elevated cholesterol more likely also. The way to verify or disprove this note would have to be by measuring the absolute production of the different hormones relative to body weight and not a single one time measurement of the blood levels of said substances, specifically growth hormone, adrenaline, cortisol and thyroxin.

2 comments:

  1. How can you say that a high sodium intake doesn't instigate high blood pressure? The ADA (American Dietetic Association) has several references that salt intake is indeed unhealthy, and is one of the main causes of hyptertension.

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  2. Hello Yacht,
    A quick brief response which I will expand on later is:
    1- The scientific rigor that the ADA has applied over the past 3 decades has been relatively weak over the references it chooses, and they are the same people who have been recommending high carbohydrate intake (around 50% calorie wise) to get healthy.
    2- If salt is the real instigator of essential hypertension then why is it that on avoidance of salt intake the essential hypertension doesn't go away and people have to be put on anti-hypertensives.
    3- The studies I have read implicating salt as the culprit have been pretty weak in its logic and causal relationship.
    4- One of our major textbooks for internal medicine (Harrison's Principles and Practice of Medicine) has come back down to admitting that there are only a small proportion of people with essential hypertension that are "salt sensitive". In this reference the study was based on infusion of salt solution (normal saline) intravenously into patients and it was seen that there was a temporary elevation of systolic pressure to the tune of about 4 torr (mmHg) which subsequently subsided pretty quickly.
    5- Essential hypertension does improve on the other hand with improved lifestyles of exercise, weight loss, increased calcium and potassium intake. Patients of mine who have hypertension and follow good lifestyles invariably either come off medications or at least need decreased doses. I never restrict their salt either (unless they have heart or kidney failure - which is a different situation).

    I will get together a more comprehensive response and when it is ready I will post it in the chapter on hypertension. If you would like to tell me which references you are alluding to, I will review them and point out the strength or weakness of each one.

    Sincerely,
    Dr. Aldoori

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