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Hypertension Part 2

An independent risk factor for stroke events in hypertensive patients is short sleep duration, defined as less than 6 hours nightly. Short sleep duration also increases the risk for cardiovascular disease, hypertension, diabetes, obesity, metabolic syndrome and myocardial infarction or heart attack. And these disease states are all INTERRELATED as you will see. Eight (8) hours appears to be the perfect sleep duration to prevent the above scenario. Prolonged sleep over 10 hours also increases your risk of the above.

So how do we define hypertension? A new definition was proposed in 2006 that states that hypertension is a PROGRESSIVE CARDIOVASCULAR SYNDROME arising from complex and interrelated etiologies, which features early markers that are often present before blood pressure elevation is sustained. Early markers of hypertension include a widening of the pulse pressure, which is the difference between the systolic and diastolic blood pressure readings, a loss of nocturnal dipping or lowering of blood pressure, a hypertensive response to exercise, salt sensitivity, increased arterial stiffness, which can be easily measured in your physician’s office, coronary artery calcification, endothelial dysfunction (the endothelium is the cellular layer lining blood vessels. When it becomes disrupted or dysfunctional, heart disease including high blood pressure can develop), microalbuminuria (microalbumin is a protein which when found in urine indicates endothelial dysfunction, heart disease and hypertension) and an elevated CRP or c-reactive protein, which is a measure of inflammation and predisposes one to heart disease and hypertension. The American Journal of Hypertension notes that there is a pre-hypertension subtype of patient with elevated CRP which increases the risk of stroke. So you see, it is not merely enough to measure the blood pressure any more. Hypertension results from an interaction of genetics and environment. Macro and micronutrients are CRUCIAL in the regulation of blood pressure. Nutrient-gene interactions and expression have either a positive or negative effect on your cardiovascular system. What I am trying to say is that lifestyle and dietary habits can determine your risk or lack of risk for this “silent killer” of a disease.

Blood CellsHypertension is now viewed as a disease of the blood vessel. It is part of vascular (blood vessel) disease and vascular aging. The best approach to manage hypertension is to improve vascular health, optimize vascular biological function and structure and SLOW vascular aging. Hypertension, like most chronic diseases of aging, results from increased oxidative stress in the blood vessels, inflammation in the blood vessels, autoimmune dysfunction of the blood vessel (in which the body attacks its own) and abnormal vascular biology with endothelial dysfunction. And each of these feeds off of and augments the others. It is a vicious cycle resulting in cardiovascular disease and, if unchecked, death.

Hypertension is a syndrome. It is more than just elevated blood pressure. There is endothelial or blood vessel dysfunction, abnormal glucose metabolism, obesity, accelerated plaque formation, abnormal insulin metabolism, abnormal lipid metabolism, blood clotting changes and kidney dysfunction.

I realize that this post in part introduces some advanced concepts in hypertension. Please contact the Giannotto Clinic or comment with any questions or concerns and I will answer.

Thanks for reading!

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