VII.11. High blood pressure

High BP affects mainly the heart, the kidneys and the brain blood vessels. Heart attack, stroke or peripheral vascular disease may develop. A high BP enhances the development of vascular wall changes, which is typical of aging. The endothelium is damaged by the permanent pressure: its permeability increases, it loses the ability to undergo vasodilatation, and it becomes unprotected against platelet aggregation. The vascular wall thickens and it becomes more rigid, and the BP therefore increases further.  

The treatment of high BP decreases the likelihood of the development of cardiomyopathy and stroke, but has no effects on CHD. The reason is that thiazides and β-blockers have no effects on Glu and lipid homeostasis.