A Dynamic Simulation Model for Long-Term Hypertension Progression

摘要

Dynamics of blood pressure over the life span of a human being demonstrates a growth path. The most significant theories which try to explain dynamics of blood pressure adopt a kidney-dependent approach. Structural reductions in the size of renal arterioles (vascular remodeling) and loss of nephrons are considered to be primarily responsible for the progressive increase in blood pressure. A dynamic simulation model is constructed to realistically reproduce the long-term progression of blood pressure in healthy and in hypertensive people. It focuses on systemic interactions that result in vascular remodeling of renal arterioles and in loss of nephrons. These hypertensive mechanisms are integrated with fluid volume and blood pressure control mechanisms which are aimed to achieve homeostatic. This study suggests that progression of blood pressure can suitably be modeled by conceptualizing the problem as a long-term control of fluid excretion capacity. The reference behaviors for normal and hypertensive people underline alternative pathways in blood pressure progression. Experiments with the model demonstrate that management of the number of remodeled arterioles over time should be an essential task in long-term blood pressure progression control. Scenario runs with the simulation model help distinguish successful policies from the ineffective interventions.