Most people, physicians included, believe that high blood pressure is a disease but I am not alone in believing that it is really just an inevitable consequence of aging.

If you only remember one thing from this posting, understand that high blood pressure occurs because, like our aging skin, the arteries become less supple as we age.

The arteries are like garden hoses that can also pump.  That’s why you can feel your pulse in your wrist and neck.  Interestingly, healthy young arteries can pump harder as they get farther away from the heart, thereby helping out with some of the forward pumping workload of the heart. That is depicted on the left by the ‘fanning out’ of the pressure measurements from “Aorta” to “Large Artery” in this purple diagram. By the time you reach the capillaries, flow is pretty constant.

But with aging,  gunk accumulates as atherosclerosis, arterial walls thicken, and the contractions of your tired arteries weaken, so the body has to somehow compensate for a LOW blood pressure being delivered to vital organs by both increasing the output of the heart (like opening the faucet) and narrowing the flow (like kinking the hose or restricting flow with your thumb).

The medicines we successfully employ to control blood pressure most often dampen the body’s narrowing mechanisms such as the adrenaline system, the salt excretion system, and the active control of the arterial diameters (the renin-angiotensin system), mechanisms which are all commonly misconstrued to be causes of hypertension, rather than its mediators.

The new paradigm considers hypertension to be body’s cure for a critical but faltering task:

the need to deliver blood away from the heart

This diagram shows three men of different ages who have normal blood pressure measured by blood pressure cuffs found in your doctor’s office (that were incidentally invented over 115 years ago.)

So their circulatory systems are all the same, right?    No.  Dead wrong!   Because “110/80” in the arm, whilst resting and seated, doesn’t tell us much about the accumulated aging of the arteries that the heart and central arterial system must contend with.

In order to maintain similar blood flow delivery depicted on the bottom chart, notice that the 28, 52, and 68 year-old heart/arteries produce very different Pulse Waves more centrally, as depicted on the top chart.  The remainder of this post explores modern Pulse Wave Analysis (PWA) that is not, but probably should be, used in your doctor’s office to understand your actual circulatory function.

——————– 21st century technology:  The Pulse Wave Analysis (PWA)

Even if you’re not a fluid engineer for NASA, you can intuitively grasp PWA by imagining you have a turkey baster that is tightly connected to a water balloon. If the water balloon is long and soft like the ones they make balloon animals with, you don’t get much bounce back on the bulb when you squeeze.

But imagine you have it connected to one of those little round ones that you can hurl at your friends; you would feel a regurgitation into your turkey baster bulb after squeezing, right?

The first, green wave of the PWA corresponds to the heart’s pumping outward (the baster’s bulb), and the second, red wave is the backwards pressure wave reflected back from arterial resistance (the water balloon’s reaction to your squeezing). The blue, third wave the sum of the first two and represents the all-important, central measurement that was shown in the three men above.

If the circulation is soft and the arteries are helping to pumping blood away, there is not a lot of reflection.

But when the arteries are hard and no longer help pump the blood away from the heart, this reflection, which was once hidden in the turkey baster wave, shows up as a distinctly separate bump now. That is called the Augmentation Pressure and is bad because it is reflective of, literally and figuratively, the hardening of the arteries and the increased blood pressure.  Higher pressure creates more turbulent flow and vessel damage, and causes the viscious cycle of atherosclerosis and the other so-called ’causes’ of hypertension (adrenaline, salt, and the renin-angiotensin system) which I am trying to convince you are just the maladaptive, but required, adjustments needed to keep adequate blood flow in an aging circulatory system.

—————–  Is this still a 65 year old man?   Not so much…

A previous post documented our real-life Benjamin Button’s improvement in his reading glasses and far vision, which we speculated was caused by softening of his lens.  Well, his arteries also softened because his Augmentation Pressure dropped from 21 mmHg to 11 mmHg and his Augmentation Index dropped from 21% to 8% after a year of the Patton Protocol!!

His softer and better-pumping arteries were confirmed by a drop in his blood pressure from 140/90 to 110/60.   And no, our client was never on, nor did he start, any medications during this year and his weight and exercise regiment reamined exactly the same.   But he was taking TA-65 for that entire year.

If you are now curious about your own circulatory age, even on current medications, please call and schedule a free consultation.