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What is High Blood Pressure?

Dr. Rob discusses the danger of high blood pressure and explains how to treat it, talking about donuts and tattoos in the process.

By
Rob Lamberts, MD
January 6, 2010
Episode #029

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What Is Blood Pressure?

In my last article I explained what blood pressure is and what it means when the nurse blows that thing up around your arm and writes down numbers with a horrified expression. This article will cover the problems that happen when blood pressure is too high and what you can do about it.

What Is High Blood Pressure?

So why does the blood pressure get high in the first place?  It doesn’t do it just out of boredom; hypertension (which is persistent high blood pressure) happens because of bad influences. Bad influences can make people do things they shouldn’t be doing, like getting tattoos in regrettable places. It’s called peer pressure. Well, think of hypertension as the peer pressure of the blood vessels.

What Affects Blood Pressure?

Here are the bad actors that can lead your vessels down the road to perdition (or at least to higher blood pressure):

The Kidneys – kidneys are supposed to filter the blood and maintain the balance of sodium, potassium, and other substances needed to keep things normal. Good kidneys will react to an increased blood pressure by lowering certain hormones in the blood, getting rid of sodium, or making you pee more . But kidneys gone bad are lazy and let blood pressure go up without raising a finger…or nephron.

The Epithelium – I just can’t get through an article without some fancy Latin or Greek word. The epithelium is a thin coating of cells on the inside of the arteries. These cells, it turns out, are very important in determining if arteries will be narrow and contracted or open and relaxed. They react to the sodium, potassium, and other substances, and change the blood pressure accordingly.

Hormones – these are substances put out by glands--such as the pituitary and adrenal glands--that have effects all over your body. Ideally they are released in response to low pressure, but when hormones go bad they wander around your bloodstream when they shouldn’t be there, when the pressure is normal .

Nerves – Some nerves have the job of relaxing or contracting muscles around blood vessels to keep the blood pressure normal. But some nerves tell the muscles to contract at the wrong time, making the pressure go too high. They’ve got a lot of nerve to do that.

The fact that there are a bunch of different bad influences is what makes treating hypertension so difficult at times; just going after one bad influence may not be enough. You have to get rid of them all in order to get the pressure back under control.

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