Hypertension – Your Blood Vessels Are Too Stressed!

Written by Yen Chi Loo
Posted on December 25, 2018

Hypertension is a silent disease. In most cases, it develops slowly in our life without any obvious symptoms. It is like a ticking bomb in your body, waiting for the day to explode, but you are not aware of it. Most of the people only discovered they have hypertension after a heart attack or stroke!

However, if your body gives you some warning signs such as dizziness, headache, fatigue and shortness of breath, maybe your body is telling you: “Your blood vessels are too stressed!”

What is hypertension?

Our heart works everyday to pump blood to all parts of our body via the circulatory system. Every time it pumps, it creates a pressure against the wall of our blood vessels. This pressure is known as “blood pressure”.

Our blood pressure can varies with the time of day or night, when we exercise, when we feel excited, angry, or when we’re stressed. But if your body has persistent high blood pressure (140/90 mm Hg and above) throughout the day, this might mean that you have hypertension!

Extra notes: The top number (In this case, 140 mm Hg) is known as systolic blood pressure, which is the pressure when your heart beats. The bottom number (In this case, 90 mm Hg) is known as diastolic blood pressure, which is the pressure when your heart rests.

Try to imagine the water hose in your garden. We have to get the water pressure right before we can water our plants. If the pressure is too low, the water hose will be too limp; if the pressure is too high, the water hose can burst!

Same goes with our blood vessels.

If our blood pressure is too low, different parts of our body, particularly our brain, will not get enough blood to function properly. Hence, we might feel dizzy and fatigue.

If our blood pressure is too high, the strong rush of the blood might damage our blood vessels, leads to heart attack, stroke and kidney failure.

People who have strong family history of hypertension has higher risk of developing hypertension in the future.

We know that DNA is what our family pass to us, but how does it play a role in regulating our blood pressure?

How does DNA relate to our blood pressure?

Perhaps you should meet your genes in your body. They are AGTR1 and STK39R! Both of them encode proteins that play an important role in regulating our blood pressure.

AGTR1 gene

For example, AGTR1 involves in producing a protein that can signal the blood vessels to constrict. When there is less space for the blood to pass through, blood pressure increases. It also helps to reabsorb water and salt from the kidney into our blood. When there is more body fluid in the blood vessels, blood pressure increases too.

Fun fact 1: AGTR1 gene variations is found to increase your risk of higher blood pressure, but also your risk of metabolic syndrome development!

A study showed that hypertension patients with this gene variation had higher fasting blood glucose level, higher triglycerides level and increase in body weight.

STK39R gene

However, the variation that occurs in these genes can increase your risk to develop hypertension. For example, STK39R gene variations was found to be directly associated with your systolic and diastolic blood pressure.

Fun fact 2: Association of STK39R gene variation with hypertension are significant in Europeans and East Asians!

This means that if you are Europeans and East Asians with this gene variation, you have higher risk of developing hypertension.

Although the mechanisms underlying are not fully understood yet, researchers believe that these genes variations affect the function of kidney to handle salt reabsorption, thus not able to control the body fluid properly and lead to hypertension.

Of course, genetic factor is just one of the risk factors of hypertension. Although you have no control over what your parents had passed to you, you can decide how you want to live. It is important to know your genetic risk, but your lifestyle plays a big part too!

What can I do to prevent hypertension?

1. Maintain a healthy weight.

If you are overweight, achieve a weight loss of as little as 1kg can actually reduce your blood pressure by 1 mm Hg. A small goal will make you stay healthier!

2. Watch out of your salt intake!

Reduce your salt intake to less than 5g of salt a day. This is equivalent to about 1 teaspoonful of salt. Avoid processed food and unhealthy snacks can help you to achieve this goal. At the same time, don’t forget to maintain a healthy diet in overall.

3. Limit your alcohol drink

Drinking alcohol excessively can increase your risk of hypertension. For those who drink alcohol, you can limit your alcohol intake to less than 2 drinks in a day.

4. Not smoking

For those who are smoking, you can consider quit smoking. It will not only reduce your risk of hypertension, but other heart-related diseases as well!

5. Move more! Have regular physical activity.

Maintain an active lifestyle of at least 150 minutes of moderate physical activity in a week. You can always start by brisk walking for 30 minutes in a day!

6. Relax! Don’t stress yourself too much!

Although the evidence for relaxing intervention is not convincing, stress management is still encouraged. So, don’t stress yourself too much, take a break and relax!

These are just some of the prevention tips for hypertension. It might be hard for you to kick off old habits (especially drinking and smoking) and starting a whole new lifestyle.

One of the recommended ways to start making changes in your life is by setting small and achievable goals in a long run, and don’t rush yourself into setting super high goals all at once. This can help you to stay motivated and determined to change.

Remember to start small, keep yourself constantly motivated, and no pressure!


References:

  1. Chandra, S., Narang, R., Sreenivas, V., Bhatia, J., Saluja, D. and Srivastava, K., 2014. Association of angiotensin II type 1 receptor (A1166C) gene polymorphism and its increased expression in essential hypertension: a case-control study. PloS one, 9(7), p.e101502.
  2. Genetic Home Reference, 2013. ATGR1 gene. Angiotensin II receptor type 1. [Online]. Available on: https://ghr.nlm.nih.gov/gene/AGTR1 [Accessed on 21 Dec 2018].
  3. Malaysian Society of Hypertension, 2018. Clinical Practice Guidelines on Management of Hypertension 5th Edition [online]. Available from: http://www.msh.my/article/543 [Accessed on 20 Dec 2018].
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  5. Mehta, P.K. and Griendling, K.K., 2007. Angiotensin II cell signaling: physiological and pathological effects in the cardiovascular system. American Journal of Physiology-Cell Physiology, 292(1), pp.C82-C97.
  6. Palatini, P., Ceolotto, G., Dorigatti, F., Mos, L., Santonastaso, M., Bratti, P., Papparella, I., Pessina, A.C. and Semplicini, A., 2008. Angiotensin II type 1 receptor gene polymorphism predicts development of hypertension and metabolic syndrome. American journal of hypertension, 22(2), pp.208-214.
  7. Persu, A., Evenepoel, L., Jin, Y., Mendola, A., Ngueta, G., Yang, W.Y., Gruson, D., Horman, S., Staessen, J.A. and Vikkula, M., 2016. STK39 and WNK1 are potential hypertension susceptibility genes in the BELHYPGEN cohort. Medicine, 95(15).
  8. Reja, V., Goodchild, A.K., Phillips, J.K. and Pilowsky, P.M., 2006. Upregulation of angiotensin AT1 receptor and intracellular kinase gene expression in hypertensive rats. Clinical and experimental pharmacology and physiology, 33(8), pp.690-695.
  9. Tang, L., Wang, Y., Bao, M., Zhang, Q. and Li, J., 2016. The rs3754777 polymorphism of the STK39 gene is associated with essential hypertension in central south Chinese Han males. Hypertension Research, 39(6), p.480.
  10. Wang, Y., O’Connell, J.R., McArdle, P.F., Wade, J.B., Dorff, S.E., Shah, S.J., Shi, X., Pan, L., Rampersaud, E., Shen, H. and Kim, J.D., 2009. Whole-genome association study identifies STK39 as a hypertension susceptibility gene. Proceedings of the National Academy of Sciences, 106(1), pp.226-231.
  11. World Health Organization, 2018. Health topic|Hypertension. [online]. Available from: http://www.msh.my/section/2/Normal [Accessed on 20 Dec 2018].
  12. Xi, B., Chen, M., Chandak, G.R., Shen, Y., Yan, L., He, J. and Mou, S.H., 2013. STK39 polymorphism is associated with essential hypertension: a systematic review and meta-analysis. PloS one, 8(3), p.e59584.

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