Американский Научный Журнал PATHOPHYSIOLOGICAL COMPONENTS OF ARTERIAL HYPERTENSION. PROSPECTS FOR PREVENTION AND REHABILITATION (37-41)

The article provides a theoretical analysis of the causes of arterial hypertension, describes a 3month observation of the initial stage of the development of hypertension and experiments on non-drug normalization of blood pressure on a group of volunteers. We show that arterial hypertension is associated with spastic conditions of the intervertebral muscles in the lower thoracic spine, which leads to compression of sympathetic nerves that control the transport of water through the kidneys, which in turn upsets the balance of fluid circulation through the circulatory system. Theoretical analysis and experimental data made it possible to formulate a hypothesis about the dominant role of disorders in the activity of the sympathetic part of the nervous system in the development of primary and persistent arterial hypertension. The possibility of prevention of arterial hypertension and non-drug rehabilitation of patients with this disease has been shown. Скачать в формате PDF
American Scientific Journal № ( 42 ) / 2020 37

УДК 612.143
ГРНТИ 76.29.51

PATHOPHYSIOLOGICAL COMPONENTS OF ARTERIAL HYPERTENSION.
PROS PECTS FOR PREVENTION AND REHABILITATION

Cherkasov A.D.
Institute of General Pathology and Pathophysiology.
Moscow. Russia. 125315, Moscow, Baltiyskaya st., 8.
Petrova E.N.
Institute for Information Transmission Problems (Kharkevich Institute)
Russian Academy of Sciences,
Moscow. Russia. 127051, Moscow, Bolshoy Karetny per. 19, build . 1.
DOI: 10.31618/asj.2707 -9864.2020.1.42.41
ПАТОФИЗИОЛОГИЧЕСКИЕ КОМПОНЕНТЫ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ.
ПЕРСПЕКТИВЫ ПРОФИЛАКТИКИ И РЕАБИЛИТАЦИИ

Черкасов Анатолий Данилович 1,
Петрова Елена Николаевна 2
1Федеральное Государственное Бюджетное Научное Учреждение
”Научно -исследовательский институт общей патологии и патофизиологии”.
12531 5, Москва, ул. Балтийская, д. 8. 2Федеральное государственное бюджетное учреждение науки
Институт проблем пере дачи информации им. А.А. Харкевича
Российской академии наук (ИППИ РАН).
127051, г. Москва, Большой Каретный переулок, д.19 стр. 1..
Abstract . The article provides a theoretical analysis of the causes of arterial hypertension, describes a 3 -
month observation of the initial stage of the development of hypertension and experiments on non -drug
normalization of blood pressure on a group of volunteer s. We show that arterial hypertension is associated with
spastic conditions of the intervertebral muscles in the lower thoracic spine, which leads to compression of
sympathetic nerves that control the transport of water through the kidneys, which in turn u psets the balance of
fluid circulation through the circulatory system.
Theoretical analysis and experimen tal data made it possible to formulate a hypothesis about the dominant
role of disorders in the activity of the sympathetic part of the nervous system in the development of primary and
persistent arterial hypertension. The possibility of prevention of arte rial hypertension and non -drug rehabilitation
of patients with this disease has been shown.
Key words : arterial hypertension, non -drug methods of treat ment, rehabilitation, spine, muscles, kidneys.

Introduction
WHO experts believe that in 95% of cases the
causes of primary arterial hypertension are unknown,
and in 85% of cases the causes of persistent arterial
hypertension are unknown [8]. Known causes of
hypertension are chronic and acute inflammatory
processes in the kidne ys, which increase both upper and
lower blood pressure. Another more rare condition is
inflammation of the adrenal glands, which leads to an
increase in pulse pressure - the differen ce between
upper and lower pressure.
The multifactorial nature of this dis ease requires a
systematic approach to studying the causes of high
blood pressure, taking into account the following
components: nervous (nervous regulation of the tone of
blood vess els), hormonal (renin -angiotensin regulation
of the tone of blood vessels) , hydrostatic (changes in
the volume of the circulatory system due to the
elasticity of blood vessels) and hydrodynamic (balance
of water transport through the circulatory system), a s
well as neurodystrophic processes in the autonomic
nervous system and ki dneys.
Russian doctor G.F. Lang believed that
hypertension was not a disease, but a reversible
functional disorder in the vascular tone regulation
system [6]. G.F. Lang regarded hype rtensive illness as
"vascular neurosis." He saw the cause of the disease i n
the obvious impact of extreme external stimuli -
conflict situations, emotional overloads. Thus, if the
"vascular neurosis" is eliminated at the initial stage,
then hypertension wi ll not arise.
Currently, official medicine believes that the cause
of hype rtension is unknown, and hypertension itself, as
a disease, is incurable. The patient must take
medications to prevent dangerous consequences for the
rest of his life.
A number of re searchers have convincingly
proven that emotional stress is one of the lea ding causes
of arterial hypertension [6, 9]. Russian scientists were
the first to present convincing evidence that the cause
of the development of arterial hypertension is primary
disorders of the nervous mechanisms of blood pressure
control [6, 1, 7].
It has been shown that baroreceptors located in the
aorta and carotid arteries are involved in the regulation

38 American Scientific Journal № ( 42 ) / 2020
of blood pressure. Baroreceptors react with an increase
in impulse activity to an increase in blood pressure and
inform the vasoconstrictor nerve cen ter of the medulla
oblongata about pressure changes [2, 3, 10]. The
frequency of baroreceptor impulses depends to a large
extent on the rate of change in pressure and to a lesser
ext ent on the level of blood pressure. The prolonged
state of high pressure l eads to adaptation of the
baroreceptors to the pressure level.
From the standpoint of pathophysiology, the
volume of the circulatory system changes
insignificantly when the pressure rises due to the
elasticity of the vessel walls, therefore, the main
mecha nism of pressure regulation is the change in the
tone of the smooth muscles of the arterial walls. At the
same time, pressure regulation mechanisms are divided
into short -acting mech anisms (reaction time of the
order of a few seconds), intermediate -acting
mechanisms (tens of seconds and minutes), and long -
acting mechanisms (tens of minutes and hours).
Short -acting mechanisms are neural mechanisms.
Signals from baroreceptors located in the aorta enter the
hypothalamus [4, 5]. From the hypothalamus the signal
goes along the sympathetic pathways of the vasomotor
nerves and comes to the smooth muscles of the arteries
and arterioles. Intermediate mechanisms of blood
pressure regulation incl ude changes in transcapillary
metabolism and relaxation of the tension in the vessel
wall. Both of these mechanisms are mechanisms aimed
at reducing pressure.
A longer -acting mechanism that increases blood
pressure is realized in the renin -angiotensin syst em.
The renin -angiotensin system is a protective system for
normalizing bl ood pressure in case of pathological
decrease in blood pressure and / or blood volume (blood
loss caused by trauma). This mechanism is also not
relevant to arterial hypertension as i t only works at low
pressure and for a limited time.
Long -term mechanisms of blood pressure
regulation include mechanisms that affect the
relationship between intravascular blood volume and
vascular capacity. It has been shown that a slight (by 2
- 3%) con stant increase in the volume of fluid in the
circulatory system when the s ympathetic nervous
regulation is turned off leads to an increase in blood
pressure by almost 50%. Normally, an increase in
pressure with an increase in the volume of fluid in the
cir culatory system is compensated by the activation of
nervous vascular refle x mechanisms of short -term
regulation, and excess fluid is excreted by the kidneys
until the adaptation of nervous mechanisms to new
conditions [13, 14].
Arterial hypertension progre sses with age and
lasts for years. There must be pathological factors that
interfere with the powerful mechanisms of blood
pressure stabilization. These factors persist for the rest
of person's life, often shortening the lifespan and
causing strokes and he art attacks.
Purpose of the study: Search for the causes of
violations of the processes of stabilization of blood
pressure and non -drug methods of normalization of
blood pressure.
The contingent of people who participated in
the research
The research invol ved 33 people - participants in
the health improvement course with an aver age age of
43 ± 7 years. The group included 3 doctors who took
part in the examinations.
Research methods
The participants underwent examinations of the
condition of the muscular cor set of the spine, which
included: the study of the mobility of the motor
segments of the spine by functional tests for lateroflexia
- bends of the spine to the right and left, manual
diagnostics of the state of the intervertebral muscles.
On the basis of f unctional tests and manual
diagnostics, we revealed the presence of spastic
conditions of the intervertebral muscles. As a
rehabilitative treatment, the participants were given
deep spinal muscle massage, which eliminated spastic
condition s of the interver tebral muscles. Each
participant underwent a massage session once a week
(for 3 to 7 weeks) and performed a set of exercises for
the spine. We studied the influence of gymnastics for
the spine and also health jogging on one participant
who had been regular ly involved in jogging and
gymnastics for 20 years. Blood pressure was measured
right before the massage and 10 minutes after the
massage with the Omron M2 Classic tonometer.
Results
In a clinical setting, for 3 months for one of the
parti cipans, we studie d the development of arterial
hypertension from the very beginning and used an
experimental non -drug effect on the patient to
normalize the blood pressure level. This is a 60 -years -
old patient (weight 74 kg, height 174 cm, no chronic
kidne y disease or any other chronic diseases for more
than 20 years), who had excellent health, was engaged
in jogging for 20 years, and had a stable pressure of
125/80 mmHg.
After prolonged stress, this participant had the
blood pressure of 193/90 mmHg with a pulse of 57 - 60.
Taking drugs that lower blood pressure, had no effect.
We applied relaxation techniques based on Chinese chi
kung, which lowered blood pressure in 3 day s. The
upper pressure dropped to 160 mmHg, and the lower
pressure increased to 110 mmHg with a pulse of 100 -
110 at rest.
This pressure level was maintained for more than
two weeks before the patient developed a sensation of
back pain in the region of th e 8th to 12th thoracic
vertebrae. The patient underwent a massage session of
the muscular corset of the spine. An hour after the
massage, the pressure dropped from 160/103 mmHg. to
the level of 137/86 mmHg., and after another 2 hours it
was stable at 130/8 3 mmHg. This level was already the
norm for the patient.
The patient continued to be in a state of chr onic
stress, and 2 weeks after the massage, the pressure
returned to the level of 160 - 180 mmHg. We again
performed 3 massage sessions with blood pressu re
control. In the first case, after the massage, the pressure
decreased from 176/97 mmHg up to 136/83 mmHg. In
the second case, after the massage, the pressure
decreased from 160/97 mmHg up to 137/88 mmHg. In

American Scientific Journal № ( 42 ) / 2020 39

the third case, after the massage, the pressur e decreased
from 159/100 mmHg up to 144/95 mmHg.
Three series of experiments were conducted with
the pa tient:
1) Tibetan gymnastics for 8 days on the shore of
the warm sea;
2) 7 experimental runs: each run in 3 stages of
1650 meters each at a speed of 10 k m / h, and
performing gymnastic exercises for the spine after each
stage;
3) 10 experimental runs of 5 km per day at a speed
of 10 km / h with Tibetan gymnastics exercises for the
spine after running. Each series of experiments resulted
in blood pressure n ormalization.
1. Rest with the daily Tibetan gymnastics "Five
Tibetan Pearls" gradually led to the nor malization of
blood pressure. We quote the figures for daily
monitoring (mmHg / hr): 160/100 - 100; 154/104 - 96;
158/90 - 94; 150/90 - 93; 152/91 - 93; 144/90 - 73;
134/82 - 75; 133/81 - 65. Indicators were measured at
the same time and under the same con ditions.
2. Experiments with a combination of running and
Tibetan gymnastics were especially revealing. The
average blood pressure at the beginning of th e day for
the first three days of the experiment was 141/89
mmHg, and at the end of the day 123/86 mmHg . Over
the past three days, the average blood pressure at the
beginning of the day was 126/83 mmHg, and at the end
of the day - 129/81 mmHg.
An experimen tal run in 3 stages of 1650 meters
each at a speed of 10 km / h and performing gymnastic
exercises for the spine after each stage led, on average,
to a decrease in the upper level of pressure from 150 to
135 mmHg and an increase in the lower pressure level
from 88 to 91 mmHg.
Functional tests for the mobility of the motor
segments of the spine and manual di agnostics showed
that stress caused spastic conditions of the muscles of
the spine in the lower thoracic region in the patient.
Massage of the muscular c orset of the spine
eliminated spastic conditions in the muscles. After
jogging and gymnastics, the spas tic states of the
muscles disappeared. We have found that the condition
of the muscular corset of the spine affects the regulation
of blood pressure. Hyp ertonicity and spastic conditions
of the intervertebral muscles in the lower thoracic spine
lead to a p ersistent increase in blood pressure. A likely
mechanism of this effect is the compression of the
sympathetic nerves that control the transport of water
through the kidneys.
Elimination of spastic conditions of the
intervertebral muscles with the help of m assage and
gymnastics for the spine regularly led to the
normalization of blood pressure.
For 6 months at the Research Institute of General
Pathology an d Pathophysiology, we studied the
influence of health -improving factors on the value of
blood pressure. We had 33 subjects - volunteers, among
whom were persons suffering from arterial
hypertension. We divided all subjects into three groups:
persons with n ormal pressure, SBP 90 - 120 mmHg -
16 people, persons with prehypertension, SBP 120 -
140 mmHg - 11 pe ople and persons with arterial
hypertension, SBP more than 140 mmHg - 6 persons.
For all of them, we applied deep spinal muscle
massage, which removes mu scle blocks in the muscular
corset of the spine, 3 to 7 times.
In persons with normal blood pressure,
immediately after the massage, the pressure decreased
on average by less than 2 mmHg. Before massage: 108
± 8.5 / 69.3 ± 7.2. After massage: 106.5 ± 12.2 / 69.5 ±
8.2 (N = 39).
In persons with high blood pressure, immediately
after the massage, the pressure decreased on average by
6.8 mmHg. Before massage: 124.8 ± 9.1 / 77.5 ± 7.6.
After massage: 118 ± 8.2 / 74.5 ± 6.0 (N = 39).
In persons with high blood p ressure, immediately
after the massage, the pressure decreased by an average
of 9 mmHg. Before the mass age, the pressure was 149
± 11.8 / 86 ± 12.6 mmHg. After the massage, the
pressure significantly decreased: 140 ± 12.7 / 87 ± 13.4
mmHg (N = 22).
Gymnast ics for the spine led to a persistent
decrease in pressure. Before the exercises, the pressure
was 147 ± 14.4 / 91 ± 6.7 mmHg. Immediately after the
exercises, the pressure rose by an average of 3 mm Hg.
and reached 150 ± 17.7 / 88 ± 6.8 mmHg. After 15
min utes, it decreased by an average of 7 mmHg in
relation to the initial and amounted to 140 ± 10/89 ± 7.4
mmHg (N = 13) and persisted for a long time (more
than 2 hours).
Jogging led to a decrease in blood pressure by an
average of 7 mmHg 10 minutes after th e end of the run.
The pressure before the start of the run was 141 ± 12.8
/ 85 ± 6.42 mmHg (N = 9). Aft er the end of the run, the
pressure dropped to 134 ± 13.2 / 87 ± 7.3 mm Hg (N =
9). An hour later, the pressure dropped to 121 ± 9.8 / 80
± 6.8 mmHg (N = 7) and remained so for up to several
hours (4 - 6).
These observations show that arterial
hypertension is associated with the condition of the
muscular corset of the spine. All volunteers who took
part in the study and had high blood pressure had
problems with the spine. Elimination of spastic
conditions in the intervertebral muscles led to the
normalizati on of blood pressure in people with high
blood pressure and a significant decrease in pressure in
people with arterial hypertension. The effect of
gymnas tic exercises for the spine and jogging on blood
pressure also confirms the existence of a neural
compo nent of hypertension. All these methods can be
recommended as preventive and rehabilitative
measures to combat arterial hypertension [11, 12].
Inflammatory processes in the kidneys - the
second cause of persistent arterial hypertension
There are two more factors that lead to arterial
hypertension.
These are inflammatory processes in the kidneys -
pyelonephritis and inflammatory processes in the
adrenal glands, leading to an increased production of
adrenaline. These are the same 15% of cases known
from the point of view of WHO experts as the causes
of persistent hypertension. In the first case, with a high
upper pressure, the lower pressure is als o high, and the
difference between them can be normal or reduced, i.e.
40 mmHg or less. In the second case, the lower pressure

40 American Scientific Journal № ( 42 ) / 2020
is normal or slightly reduced, and the difference
between the upper and lower pressure is 60 to 100
mmHg.
Such a big difference i s caused by the powerful
cardiac output under the influence of adrenaline, but the
cause of the adrenaline relea se is not a stress, but the
inflammatory process in the adrenal glands. This
condition manifests itself as a sympatho -adrenal crisis.
And until the inflammatory process in the adrenal
glands disappears, the upper pressure will not decrease.
There is a thir d option - simultaneous inflammation of
the kidneys and adrenal glands. In this case, a high
value of lower pressure and a large difference betw een
the upper and lower pressure are possible. In both of
these cases, it is necessary to eliminate the causes o f the
inflammatory process.
In our practice, we have encountered conditions
characterized by a pressure of 193/100 mmHg, 208/110
mmHg and even 2 34/115 mmHg with a pulse below 70
beats per minute. These conditions were also reactions
to stress, but they dis appeared only after the elimination
of inflammatory processes in the kidneys and adrenal
glands. The cause of the inflammatory processes was
the accumulation of metabolites in the blood, caused by
the poor condition of the large intestine, and
hypothermia of the kidney area was the provocateur.
In our health -improving activities, we have also
encountered a combination of nervous and
inflammatory p rocesses. Another provocateur of a rise
in pressure is a persistent pathological reflex caused by
nervous overst rain or persistent neurosis. In the
presence of an inflammatory process in the adrenal
glands, a slight nervous tension is enough and the
pressu re rises dramatically to 200/100 mmHg, and
more up to 234/110 mmHg. This rise in pressure is
caused by an increa sed release of adrenaline and, as a
consequence, an increase in myocardial contraction and
an increase in cardiac output.
In the presence of an inflammatory process in the
adrenal glands, a slight nervous tension is enough and
the pressure rises dramatical ly to 200 mmHg and more.
In this situation, it is necessary to eliminate not only the
inflammatory process, but also neurosis and nervous
tensio n caused by mental work. It is necessary to
engage in physical activity and disconnect for a long
time from inte nse mental activity.
Discussion
Analysis of the causes of arterial hypertension.
Water transport through the circulatory system
Every day, up to 10 liters of fluid is absorbed into
the circulatory system and excreted from it, which is
almost 2 times the volume of blood in the circulatory
system. This is up to 3 liters of water consumed with
food, up to 6 liters of digestive juices produced by th e:
stomach (2.5 liters), pancreas (0.7 liters) and the
proximal part of the small intestine (the first half of t he
small intestine, 2.5 liters ). All these 10 liters are
absorbed back into the circulatory system in the distal
part of the small intestine an d along the entire length of
the large intestine.
From the intestinal wall, the blood passes through
the liver a nd is pumped back into the bloodstream.
Another way of injecting fluid from the intestine into
the circulatory system is through the lymphatic s ystem
of the small intestine through the main lymphatic vessel
into the subclavian vein (on average, up to 1 lit er per
day). In addition, the oxidation of carbohydrates in the
body produces additional 0.5 liters of metabolic water.
Some of the water is exc reted from the body through
respiration and sweat, but most of it is excreted by the
kidneys. At the same time, the level of blood pressure
remains stable. In fact, there is a “third circle of blood
circulation” in the circulatory system - the circulation
of fluids through the circulatory system .And whatever
the blood pressure, and whatever the tone of the blood
ves sels, the "pumps" of the small and large intestines
will still "pump" these 10 liters of fluid into the
bloodstream. This volume of fluid from t he circulatory
system will be transported back to the gastrointestinal
tract, and its excess will be excreted fr om the body
through the kidneys. In this case, the question arises:
what kind of system maintains the balance in the
movement of 10 liters of fl uid per day (200% of the
volume) through the circulatory system? It is quite
obvious that this is the metasympat hetic nervous
system of the kidneys controlled by the hypothalamus.
With an increase in pressure by 1 mmHg excretion of
water by the kidneys inc reases by 100%. The excretion
of water by the kidneys can increase by 8 times even
with a slight increase in blo od pressure up to 10 mmHg
[13]. This is what stabilizes blood pressure under the
control of the hypothalamus. The denervated kidneys
reduce thei r characteristic "pressure - speed of water
transport" by 6 - 8 times [13].
The sympathetic nerves of the kidney s exit the
spine at levels 9, 10, and 11 of the thoracic vertebrae.
When muscle blocks appear in this part of the spine,
compression of sympathe tic nerves is possible, which,
unlike motor and sensory nerves, do not have a strong
myelin sheath. Compression of the sympathetic nerves
that control the kidneys manifests itself similarly to
denervation, and switches the kidneys to be controlled
by their own metasympathetic nervous system; the
kidneys continue to stabilize blood pressure, but at a
higher level. In fact, we are dealing with functional
partial denervation of the kidneys. This is what we see
as the main reason of arterial hypertension.
We be lieve that the data we have obtained are
sufficient for the formation of a hypothesis that needs
to be tested in a clinical setting.
Hypothesis
Persons suffering from persistent arterial
hypertension also have a stabilization of blood
pressure, but at a higher level. Control over the level of
pressure is carried out by the sympathetic division of
the nervous system along the chain: baroreceptors,
hypothalamus, sympathetic nerve paths passing inside
and out of the spine in the region of thoracic vertebrae
9-11, sympathetic fibers of the spinal nerves, neurons
of the sympathetic trunk, neurons of the celiac ganglion
and metasympathetic nervous system of kidneys.
Fibers of the sympathetic nerves do not have a strong
myelin sheath and can be compressed as they pass
between the stiff spasmodic muscles of the spine. When
the sympathetic nerve fibers of the kidneys are
comp ressed in the region of the 9 -11 thoracic vertebrae,

American Scientific Journal № ( 42 ) / 2020 41

the normal control of fluid excretion from the
circulatory system is impaired. The meatsympathetic
nervous system of the kidneys, which has a higher
threshold for regulating the pressure of fluid transpo rt,
stabilizes the volume of flui d in the circulatory system,
but already at a higher blood pressure. This, regulation
at a higher level of blood pressure manifests itself as
persistent arterial hypertension.
Rehabilitation measures to restore the sympathe tic
innervation of the kidneys (m assage, gymnastics for the
spine and good rest) are aimed at eliminating spastic
conditions of the intervertebral muscles. They are able
to prevent the development of hypertension at its initial
stage. At later stages of th e development of arterial
hyperte nsion, dystrophic processes in the sympathetic
innervation and metasympathetic nervous system of the
kidneys are very likely, which will not allow one to
quickly defeat the state of arterial hypertension.
However, this does not mean that rehabilitation
mea sures will be useless. Massage of the muscular
corset of the spine leads to a prolonged decrease in
pressure from 7 to 15 mmHg. A regular and long -term
healing effect on the muscular corset of the spine leads
to the disappe arance of muscle blocks and elimi nates
the compression of the sympathetic nerves emerg ing
from the spine as part of the spinal nerves [12].
Conclusions .
1. Primary arterial hypertension is not a disease,
but a reversible functional disorder in the sympathe tic
part of the nervous system, w hich regulates the
excretion of fluid from the circulatory system through
the kidneys.
2. Rehabilitation measures to eliminate spastic
conditions in the intervertebral muscles and to restore
the sympathetic innervation of the kidneys (massage,
gymnastics for the spine and good rest) can prevent the
development of hypertension at its initial stage.

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