You are chatting with your uncle at a family reunion and he mentions that he is

Question

You are chatting with your uncle at a family reunion and he mentions that he is being treated for high blood pressure, but that he’s not convinced his doctor “knows what she’s talking about”. Your uncle is very upset that he has been advised to restrict salt intake, lose weight, and commit to at least thirty minutes of exercise every day. He thinks the doctor is overreacting and that his heightened blood pressure is “no big deal”. How would you explain the internal control of blood pressure, and how would you relate the recommended lifestyle changes to what you know of blood pressure homeostatic control mechanisms to your uncle?

Instructions/expectations

“If you can’t explain it simply, you don’t understand it well enough.” – Albert Einstein

One of the ways to test yourself on your mastery of complex topics is to try to communicate effectively and succinctly to somebody who has no background in your topic of interest. Each week you will be provided with a prompt and you will give a brief oral presentation (no longer than three minutes) as if you were teaching the topic of interest to your 10 year old niece or your 95 year old grandfather. You are welcome to use diagrams or sketches to help illustrate concepts. Your weekly presentation will be graded by the course instructor.

Explanation / Answer

All the three measures to control blood pressure i.e reduce salt intake, lose weight and 30mins of exercise daily are a must for a hypertensive patients on treatment.

Here is the reasoning for the above:

Restrict salt intake- As higher intake of NaCl (salt)results in higher amount of salt in blood stream thus increasing the load over kidney to prevent water excretion. Higher the water retention higher will be the fluid load and higher will be the blood pressure.

Lose weight-Obesity is associated with increased blood flow, vasodilatation, cardiac output, and hypertension. Although cardiac index (cardiac output divided by body weight) does not increase, cardiac output and glomerular filtration rate do. However, renal sodium retention also increases, leading to hypertension.The factors generally considered responsible for obesity-related alterations in the pressure-natriuresis curve (derangement in arterial pressure and natriuresis i.e excretion of NaCl relationship)include enhanced sympathetic tone, activation of the renin-angiotensin system (RAS), hyperinsulinemia, structural changes in the kidney, and elaboration of adipokines (hormones produced in fat itself) such as leptin.

Daily 30 mins of exercise-Exercise alone is associated with reductions of approximately 3.5 and 2.0mm Hg in systolic (SBP) and diastolic blood pressure (DBP), respectively.

Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. If your heart can work less to pump, the force on your arteries decreases, lowering your blood pressure.

Also hypertension is the prime risk factor of further development of atherosclerosis which means blockade of coronary artery either partially or completely. So by exercising briskly you make your heart capable of forming new small coronary arteries by itself which further prevents the complications in cases of atherosclerosis which otherwise may lead to myocardial infarction.

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