Control of Blood Pressure - Causes of High Blood Pressure (Hypertension) and Lifestyle Changes to Reduce High Blood Pressure
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Control of Blood Pressure - Causes of High Blood Pressure (Hypertension) and Lifestyle Changes to Reduce High Blood Pressure

Hypertension is a common medical condition which may have significant impacts on a personÂ’s overall health and quality of life. An understanding of the bodyÂ’s physiological mechanisms of blood pressure control, in addition to the causes of high blood pressure and lifestyle changes which may assist in lowering blood pressure, are important for people with - or at risk of developing - hypertension.

Hypertension - or high blood pressure - is a common medical condition which may have severe, long-term consequences for sufferers. If inadequately managed, hypertension may cause irreversible organ and vessel damage, and it may also have significant impacts on a patient’s overall quality of life. This article discusses the body’s physiological mechanisms for controlling blood pressure, and outlines some simple lifestyle changes which may assist in lowering blood pressure in patients at risk of chronic hypertension.

Blood pressure is controlled by the body’s renin-angiotensin-aldosterone system, a complex cascade of chemical events. Blood pressure control begins with the baroreceptors – highly-specialised, super-sensitive cells within the kidneys which monitor rates of renal perfusion. The baroreceptors are activated in situations of hypotension, or low blood pressure, where they stimulate the release of the enzyme Renin from the kidneys. Renin then causes the release from the liver of a chemical named Angiotensin I, and this is next converted into a smaller chemical referred to as Angiotensin II.

Angiotensin II acts in two important ways to control blood pressure. Firstly, it may act on the blood vessels to cause vasoconstriction - a systemic narrowing of the vasculature. Vasoconstriction reduces the size of the vessels through which the blood travels, and thereby increases blood pressure. Secondly, Angiotensin II stimulates the adrenal cortex, the gland which sits above the kidneys, to produce the hormone aldosterone. Aldosterone causes the reabsorption of sodium ions and water from the urinary filtrate, and it also causes the release of antidiuretic hormone from the posterior pituitary of the brain (thereby triggering the thirst reflex). Both of these actions increase blood plasma volume, and in doing so raise blood pressure.

A negative feedback cycle controls the renin-angiotensin-aldosterone system. When the baroreceptors in the kidneys sense an increase in blood pressure, they reduce their production of Renin and the system gradually returns to a homeostatic balance. High blood pressure (hypertension) occurs when the homeostatic balance of the renin-angiotensin-aldosterone system is unable to adequately cope with certain conditions within the body.

There are a number of lifestyle changes which may be recommended to hypertensive patients to assist them in controlling their high blood pressure. Lifestyle changes may delay or eliminate the need for the commencement of antihypertensive medication. Lifestyle changes also underpin the effectiveness of pharmacological intervention, if this becomes necessary.

Consumption of a healthy, low calorie diet has been shown to have a modest effect on reducing hypertension, particularly in overweight or obese patients where cholesterol-based vascular occlusion and related cardiac complications may contribute to high blood pressure. A sustained weight loss in such patients may also result in a reduction in blood pressure. Weight loss may be achieved through frequent aerobic exercise, which in itself contributes to a drop in both systolic and diastolic blood pressure.

Interventions combining improvements in both diet and exercise have been shown to have the greatest positive impact on reducing hypertension. Decreasing the intake of dietary sodium may cause blood pressure to fall, as sodium ions result in the retention of water and potential hypervolaemia (high blood volume, resulting in higher blood pressure). Similarly, limiting the excessive consumption of caffeine-rich products and/or alcohol, as well as minimising the use of tobacco, have been associated with a decrease in blood pressure, however the specific reasons for this are still being researched.

Where hypertension cannot be controlled by lifestyle interventions alone, antihypertensive medications - which interfere with the renin-angiotension-aldosterone system to promote a reduction in blood pressure - may be prescribed.

Hypertension is a common medical condition which may have significant impacts on a person’s overall health and quality of life. An understanding of the body’s physiological mechanisms of blood pressure control, in addition to the causes of high blood pressure and lifestyle changes which may assist in lowering blood pressure, are important for people with - or at risk of developing - hypertension.

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