We welcome you back to our weekly educational series from 3rd year medical student Adham Ahmed, and as always, we appreciate you joining us again.
Last week, we discussed hypertension and ways to help control it. We also had a small discussion about what each number in a blood pressure reading tells us.
Have you ever wondered how one even develops high blood pressure?
Today, we are going to be sharing some information about the underlying pathways by which high blood pressure arises using a wonderful article from the Cleveland Clinic.
One of the most important mediators of hypertension is a system called “The renin-angiotensin” system, and it has some big players!
Angiotensinogen
This is a large protein produced by your liver which acts as the
“blueprint” for the system. On it’s own, the protein will not directly raise your blood pressure however, when your kidneys feel a decrease in fluid
in your body (or do not receive enough blood flow) it releases the next
big player ->
Renin**
This enzyme comes from the kidney and works to cleave
angiotensinogen into angiotensin I.
Once again, on it’s own this protein will not do much, however it travels to the lungs to undergo its next major change ->
Angiotensin-converting enzyme (ACE)**
ACE is an enzyme in the lungs which converts angiotensin I into
angiotensin II. Unlike our first two steps, this is where WE GET SERIOUS!
Angiotensin II raises blood pressure in two ways:
-Directly -> it causes blood vessels to narrow causing an elevation in your body's overall pressure
-Indirectly -> it stimulates our adrenal glands to produce the final big boss in this pathway
Aldosterone**
Aldosterone is produced by our body’s adrenal gland’ and is released into our bloodstream under the influence of angiotensin II. It then goes on to the kidneys and directs it to absorb more salt and water from our urine.
More fluids and salts in the body, means more volume in our blood
vessels, means more pressure overall
These names might sound overwhelming at first! Do not worry but try to think of them in a step-wise fashion.
Remember- (TIPS from a medical student that painfully had to memorize all
these!!!) 😊
We start with angiotensinogen which is the longest word in the pathway
Gets CUT into a smaller word / protein ->
Angiotensin I by Renin from the Renal system (kidneys)
Angiotensin I gets CONVERTED into Angiotensin II in the lungs by angiotensin CONVERTing enzyme.
Angiotensin II goes to the ADrenaL glands to release ALDosterone.
Be sure to pay extra close attention to the words we put a “**” next to! They will come in helpful next week as we learn about some common drugs used to control blood pressure!
Thank you very much for tuning in and as always our family here
thanks you for taking this journey with us. Be safe, be happy and always remember to Think Aorta! Until next time friends.
~Adham
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