Hypertension Pathophysiology - Understanding the Mechanisms of High Blood Pressure Formation

Hypertension is a systemic disease. This means that high blood pressure affects many organs and systems in the body and not just the cardiovascular system. Usually function follows form and as such, when ever there is an abnormal biochemical or biophysical derangement, the physiology of the body changes from normal to diseased condition. Pathophysiology is the mechanism or process of how normal blood pressure turns into a medical condition called hypertension. Knowledge of pathophysiology of hypertension will offer a pathway to reverse the dis-ease process back to normalized blood pressure.

The heart and the blood vessels has a pump and pipe arrangement. Blood pressure is the force the heart exerts on its chambers and the arteries when it pumps blood to the general circulation. It is the force of this push that powers oxygenate blood to the general circulation. Systolic blood pressure records the peak of this force while diastolic blood pressure measurement records the relaxation in between systolic ejection forces.

Therefore primarily, anything can go wrong with the arterial wall, the blood viscosity, or the end organs like the kidneys and the liver. Poor diet like processed food, refined sugars, fried foods, hydrogenated oils, high fructose corn syrup, lack of magnesium and other essential minerals can aggravate these sluggish organs.

Poor dietry habits, and poor lifestyle all lead to creating one factor: inflammation. Inflammation is the seed bed for all pathophysiological mechanisms of hypertension. The cholesterol theory has been debunked because majority of people with arteriosclerotic hypertension and heart attacks have normal cholesterol level. High blood acidity, oxidative stress, and fibrosis follows chronic low-grade inflammation which can go on for years before hypertension shows up.

Here are four pathophysiological mechanisms responsible for hypertension manifestation:

  • Total peripheral resistance (atherosclerosis or plaque build-up): Peripheral resistance is a fancy way of saying that the blood vessel pipes have become rigid and inelastic and can no longer accommodate the systolic pumping pressure of the heart. This starts with endothelial dysfunction triggered by inflammation of the vascular wall by high blood acidity and free radicals. The vessels react by protecting themselves with plaque build-up worsened by lack of vitamin C. The liver responds by producing cholesterol (LDL) to patch the cracks in the vascular wall. This is how repair factor becomes risk factor or atherosclerosis. With cholesterol comes calcium, heavy metals, fibrosis and foam cells all trying to fix the damage.
  • glomerulosclerosis (hardening of the filtration apparatus of the kidneys): The kidneys filter blood and clear it of debris and acidic wastes. The same mechanism of atherosclerosis can clog and disorganise the kidney filters called the glomerulus. When this happens, blood inflow becomes greater than outflow. Unwanted pressures build up in the kidneys sensitive low pressure beds. This creates a potential pressure difference in the renal vasculature. The sluggish kidneys may now depend on raised vascular pressure to maintain perfusion. This is how some hypertensives complain of blood in the urine.
  • Increased blood viscosity (sticky blood): The blood of most people are like yogurt in an old water host instead of flowing like water from a fresh pipe. This is because the blood is not just the river of life; it is the river of litters (some call it the river of death). This is because 95% of people have all kinds of junk and gunk in their blood stream. These include fibrin clots, oxidants, pro-inflammatory cells due to processed foods. All kinds of immune cells cluster around the blood to fight inflammation creating more damage if they stay past the time for repairs. About 20 factors (calcium, fibrin, vitamin K, etc.) lead to clot or thrombus formation while only one factor: plasmin lead to dissolution of clots. Therefore, any substance which can safely dissolve excessive clot formation can prevent or cure hypertension.
  • Sluggish or congested liver: The liver is the largest internal organ in the body. It is like a giant biochemical factory or the body internal laboratory performing more than 500 functions. None of us can live without the liver. When we hear naturopaths say that the body can heal itself, it is the liver that performs most of the repair and regeneration functions. Hypertension is no exception to this rule. The liver filters the blood and manufactures most enzymes that regulate digestion and other systemic functions. When the liver is sluggish or congested, it does not function well. It begins to produce excess C-reactive proteins which is a marker of inflammation and atherosclerotic heart disease. This is even more important in pathogenesis of hypertension than cholesterol. The liver also recalls bad cholesterol for processing and excretion through the gut. Flushing constipated liver with liver-friendly herbs like milk thistle, bitters, cucumbers, dandelion greens and other green leafy vegetables is necessary to clean-up the liver and encourage bile flow. Once the liver is healthy, it is hard to get hypertension, coronary artery disease or stroke.

One central mechanism of hypertension causation is inflammation. Do not buy the lie of the synthetic drug industry that cholesterol elevation is the sole cause of hypertension. The seed-bed is high blood acid setting the stage for inflammation which in turn set the stage for fibrosis and atherosclerosis. Yes, you are as healthy as the elasticity of your blood vessels. Therefore, fibrinolytic enzymes like nattokinase and serratiopeptidase can reverse the above damage caused by inflammation and fibrosis. It is also necessary to eat alkalizing foods which also help the detoxification of the liver and combat inflammation.


Uzo Onukwugha comes back to discuss hypertension.