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Is it
really only our kidneys that control blood
pressure?
The problem of high blood pressure has
reached pandemic proportions, causing
premature death through heart attacks,
strokes and kidney disease in a third of the
UK population.
For decades, scientists have battled at
length over its cause yet still cannot
agree; is the kidney or the brain to blame?
This month, Experimental Physiology hosts a
lively debate between two groups of
world-leading experts.
In the first ever published dialogue on the
topic, Drs Montani & Vliet and Drs Osborn,
Averina & Fink share their opinions with us
and criticise each-other's theories.
heir frank exchange of views provides an
interesting and informative summary of the
latest research into how blood pressure is
controlled.
When blood pressure increases the kidneys
respond by extracting extra water and salts
into the urine, causing blood volume — and
hence pressure — to fall.
But special nerve pathways mean the brain
can also regulate urine production and hence
influence blood pressure. So which organ is
really in charge?
Montani & Vliet argue that controlling blood
volume is the key, as the kidney
automatically makes more urine as blood
pressure increases.
However, Osborn and colleagues remind us
that the cardiovascular system is controlled
by multiple mechanisms including the
automatic part of the nervous system, which
directly controls the kidney.
They also update us on a plethora of new
findings supporting a role of the nervous
system in controlling blood pressure long
term.
But both groups acknowledge that new
mathematical models are needed that
incorporate both the kidney and the brain
control systems.
So the question of whether it is the kidney
or the brain that has a firmer grip on the
reins for controlling blood pressure may
have to wait for a mathematician to answer.
Professor David Paterson, the Chief Editor
of Experimental Physiology and instigator of
the debate, said: "This frank exchange of
views was needed as it highlights major
issues that remain with blood pressure
control and will undoubtedly guide future
studies to reveal fundamental new knowledge
that will inform the future treatment of
high blood pressure."
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