Want to Diagnose Artery Disease Early? Just Check the Blood Pressure!
High Blood Pressure is a Measurement that Points to An Abnormal Artery
Current thinking on vascular disease is as out of date as the rotary telephone. I asked ChatGPT if patients with high blood pressure have artery disease. The answer reflects current dogma.
“Having high blood pressure (hypertension) does not necessarily mean that you already have vascular disease, but it does significantly increase your risk of developing vascular problems over time. Hypertension is a condition where the force of blood against the walls of your arteries is consistently too high. Over time, this elevated pressure can damage the blood vessels throughout your body, including the arteries that supply blood to your heart, brain, kidneys, and other organs.”
That understanding of high blood pressure dates to the time of the rotary telephone. Many of you are too young to know what that is. Let’s just say it is based on science that is completely outdated.
By definition, disease is a disorder of structure or function. By the time the blood pressure becomes high, the artery is abnormal in both structure and function. By definition it is diseased—abnormal. Lab animals fed a high-fructose diet (which most Americans eat) gain weight, develop resistance to the hormone insulin, and their arteries don’t expand as well with exercise to increase blood flow. They have a disorder of arterial function. Structural abnormalities in arteries also precede blood pressure elevation. Hormones produced from abdominal fat produce changes in arterial structure and function prior to developing high blood pressure. Once high blood pressure occurs, it does further damage to the artery, but it does it by reinforcing the epigenetic changes and molecular biology that increased the pressure in the first place.
This simple fact has huge implications for treating vascular disease and updating our medical system. Losartan precisely blocks the effects of the hormone produced from abdominal fat. (angiotensin II) Treating high blood pressure with losartan reverses the structural and functional changes in the artery that increase the blood pressure. When atenolol and losartan are used for a year to achieve the same blood pressure, the structure and function of the artery becomes more normal in the patients treated with losartan. They are unchanged in patients treated with atenolol. The pressure reduction achieved was the same. The effect on vascular disease was completely different. The same effect was seen in patients with high-risk diabetes.
This understanding of high blood pressure is absolutely critical. The same gene regulation and molecular biology that we often discuss support arterial cell growth, programmed cell death, inflammation, and scar formation to make arterial structure and function abnormal. These processes that lead to hypertension directly damage the artery. They also directly damage the heart, kidney, and liver. The best treatment for vascular disease and abnormal arteries blocks these damaging hormones directly and protects every other cell and organ in the body.
If you think of blood pressure in purely physical terms as a risk factor for vascular disease, treating hypertension is a preventive service. But if you understand that structure and function of the artery are abnormal when you first develop high blood pressure, and that we can improve structure and function through lifestyle and medical measures, that becomes the most effective treatment of vascular disease. The same biology that causes high blood pressure leads to more rapid aging and other chronic diseases. It is time to move beyond the rotary phone and bring the benefits of precision medicine to our patients.
Once again a great reminder which I will share in hopes to help people.