Dangerous versus useful hypertension (a holistic view of hypertension).
The authors aim to offer a holistic view on hypertension and its treatment. Their approach is fairly confrontational, particularly by suggesting that hypertension may play a role in optimizing the blood flow and enhancing oxygen delivery. An increase in blood pressure brings about a threat of catastrophes. Therefore hypertension might be considered as either a subsequent complication, or an inevitable adaptation. When changes of many complicated and complex mechanisms result in retention of sodium and water, then the treatment of this condition is so far the most logical conclusion, and possibly beneficial to the patient. This can be done by influencing the peripheral resistance or the load of vascular bed. However, in some cases a moderate overfilling of the system with no increase in heart rate could be interpreted as an optimal solution for organism that does not necessarily need to be medically treated. This may apply especially to young hypertensive patients, and in cases when no catastrophe is assumed to take place. Lowering the blood pressure to average population levels in each case, especially by means of aggressive therapy may not necessarily lead to improved tissue perfusion. A decrease in blood pressure reduces the risk of catastrophes. However, on the other hand, it can deteriorate the tissue perfusion and cause unfavorable long-term consequences.
Hulin
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I
Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia. ivan.hulin@fmed.uniba.sk
Duris
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I
Paulis
L
L
Sapakova
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E
Mravec
B
B