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A Dynamic Simulation Model for Long-Term Hypertension Progression

机译:长期高血压进展的动态模拟模型

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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 homeostatis. 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.
机译:在人类的整个生命周期中,血压的动态变化表明了其增长之路。试图解释血压动态的最重要理论采用了肾脏依赖性方法。肾小动脉大小的结构性减少(血管重塑)和肾单位丢失被认为是导致血压逐渐升高的主要原因。构建了动态仿真模型,以真实再现健康和高血压人群的长期血压变化。它着重于导致肾小动脉血管重塑和肾单位丢失的系统性相互作用。这些高血压机制与旨在实现体内平衡的体液量和血压控制机制结合在一起。这项研究表明,可以通过将问题概念化为对液体排泄能力的长期控制,来适当地模拟血压的升高。正常人和高血压人的参考行为强调了血压发展的替代途径。该模型的实验表明,长期控制重塑小动脉数量应该是长期血压进展控制中的一项基本任务。模拟模型运行的场景有助于将成功的策略与无效的干预措施区分开。

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