Hypertension: have we missed something?


IF you were wearing red on February 5th, chances are that you already know February is American Heart Month. For its part, the slogan this year for the Centers for Disease Control and Prevention is “Make blood pressure control your goal.” The aim is to prevent a million heart attacks and strokes in the US by 2017.
High blood pressure (BP), or hypertension, affects some 70 million Americans, quadrupling the chance of a person dying from a stroke and tripling the chance of dying from heart disease.
Physicians prescribe medications to lower BP but with limited effect. Some people do not see the benefit, some may suffer unwanted side effects and others may hear stories about adverse effects that cause them to discontinue treatment, as previously reported by Medical News Today. For many, it may be that the treatment is not targeting the underlying cause.
Hypertension that results from a medical condition, such as obstructive sleep apnea, adrenal gland tumors or thyroid problems, is called secondary hypertension. This type of high BP can result from medications such as hormone treatments and painkillers, recreational drugs and even herbal remedies. Secondary hypertension usually starts suddenly and causes higher blood pressure than primary hypertension.
Over 90% of people with high blood pressure have primary hypertension. It progresses gradually over the years, increases with age and is affected by hereditary factors. Lifestyle factors, such as too much salt, lack of exercise, obesity or heavy alcohol consumption can cause primary hypertension.
While advice and treatment for high BP mainly focuses on lifestyle factors or dysfunction of the cardiovascular system, some researchers are looking elsewhere. This spotlight will touch on some new approaches to hypertension.
According to the American Academy of Neurological and Orthopedic Surgeons (AANOS), hypertension “is not only a problem of the heart, kidneys or blood vessels but also of the central nervous system.” Prof. Julian Paton and colleagues, from Bristol University in the UK, are among researchers studying the relationship between high BP and the brain, and particularly the nerves in the brainstem. To understand the role of the nervous system in blood flow, we will start by looking at the autonomic and sympathetic nervous systems. Some of our actions, we control; we choose to raise our hands or close our eyes.But we cannot normally choose to breathe or to stop our heart from beating. It is the autonomic nervous system that controls involuntary actions such as cardiovascular system function.

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