Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Review Article Volume 6 Issue 5

Hypertension and the Interior Ion-milieu. Can we Overcome Hypertension with Regulated Breathing?

András Sikter*

Municipal Clinic of Szentendre, Internal Medicine, Szentendre, Hungary

*Corresponding Author: András Sikter, Municipal Clinic of Szentendre, Internal Medicine, Szentendre, Hungary.

Received: March 15, 2022; Published: April 22, 2022

Abstract

The author presents a new model for age-associated diseases through a hypothesized pathogenesis of hypertension. Preservation or restoration of the constancy of each original cell-specific intracellular ion-pattern is essential for upholding cellular identity and integrity. The ageing background is intracellular acidosis: low-grade respiratory acidosis elevates the intracellular HCO3-/Cl- gradient and induces metabolic syndrome, while low-grade metabolic acidosis causes exhausting buffer syndrome (EBS) with a decreased intracellular HCO3-/Cl- rate. The former elicits higher aldosterone levels to restore the original ion-pattern by NHE-1 (natrium-hydrogen exchange) mechanism located in the membrane of vascular smooth muscle cells (VSMCs) and by retaining NaCl. The fault of ion-status restoration leads to Salt-sensitive hypertension through cascades of events. The ion-pattern changes in EBS elicit angiotensin II levels elevation through the renin-angiotensin system, which tries to eliminate intracellular changes via NBCn1 (natrium-bicarbonate cotransporter). However, it leads to a dead-end, and Salt-resistant hypertension develops. Hypertension occurs because restoring the original intracellular ion-pattern in VSMCs by aldosterone and angiotensin II fails. These hormonal counter-regulations lead to Na+ retention and alkaline overcompensation in the VSMCs. There may be several explanations for the failure, but hypertension would not develop if the intracellular ion-milieu were initially neutral or slightly alkaline. Regulated breathing could overcome hypertension.

Keywords: Age-associated Diseases; Exhausting Buffer Syndrome (EBS); Hypertension; Intracellular pH Homeostasis; Metabolic Syndrome; Signalling by Intracellular Ion-pattern

References

  1. Bruton A and Holgate ST. “Hypocapnia and asthma: a mechanism for breathing retraining?”. Chest 5 (2005): 1808-1811.
  2. Sikter A., et al. "New aspects in the pathomechanism of diseases of civilization, particularly psychosomatic disorders. Part 1. Theoretical background of a hypothesis”. Neuropsychopharmacologia Hungarica2 (2017): 95-105.
  3. Hayflick L. “Entropy explains aging, genetic determinism explains longevity, and undefined terminology explains misunderstanding both”. (Editorial) PLoS Genetics12 (2007): e220.
  4. Goldstein DS and Kopin IJ. “Evolution of concept of stress”. Stress 10 (2007): 109-120.
  5. Bitman-Lotan E and Orian A. “Nuclear organization and regulation of the differentiated state”. Cellular and Molecular Life Sciences 7 (2021): 3141-3158.
  6. Fisher AG. “Cellular identity and lineage choice”. Nature Reviews Immunology12 (2002): 977-982.
  7. Orlov SN and Hamet P. “Intracellular monovalent ions as second messengers”. The Journal of Membrane Biology 3 (2006): 161-172.
  8. Newton AC., et al. "Second messengers”. Cold Spring Harbor Perspectives in Biology8 (2016): a005926.
  9. Sikter A. “Psychosomatic molecular mechanisms of metabolic syndrome and type 2 diabetes. Part 1. A theory for modelizing the cytoplasm and diseases”. Acta Scientific Medical Sciences1 (2020): 124-140.
  10. McEwen BS and Stellar E. “Stress, adaptation and the individual. Mechanisms leading to disease”. Archives of Internal Medicine 153 (1993): 2093-2101.
  11. Brouillard C., et al. "Long-lasting bradypnea by repeated social defeat”. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 311 (2016): R352-364.
  12. Sikter A., et al. "New aspects in the pathomechanism of diseases of civilization, particularly psychosomatic disorders. Part 2. Chronic hypocapnia and hypercapnia in the medical practice”. Neuropsychopharmacologia Hungarica3 (2017): 159-169.
  13. Relman AS. “Metabolic consequences of acid-base disorders”. Kidney International 1 (1972): 347-359.
  14. Sikter A. “Hypocapnia and mental stress can trigger vicious circles in critically ill patients due to energy imbalance: a hypothesis presented through cardiogenic pulmonary oedema”. Neuropsychopharmacologia Hungarica2 (2018): 65-74.
  15. Panel M., et al. “Mitochondria and aging: A role for the mitochondrial transition pore?”. Aging Cell4 (2018): e12793.
  16. Peuhkurinen KJ. “Ischemic heart disease at the cellular level”. IJBEM 1 (2000): 1-9.
  17. Deprez MA., et al. "pH homeostasis links the nutrient sensing PKA/TORC1/Sch9 ménage-à-trois to stress tolerance and longevity”. Microbial Cell3 (2018): 119-136.
  18. Laffey JG., et al. "Therapeutic hypercapnia reduces pulmonary and systemic injury following In Vivo lung reperfusion”. American Journal of Respiratory and Critical Care Medicine 162 (2000): 2287-2294.
  19. Jaul E and Barron J. “Age-related diseases and clinical and public health implications for the 85 years old and over population”. Frontiers in Public Health 5 (2017): 335.
  20. Osanai T., et al. "Intracellular protons accelerate aging and switch on aging hallmarks in mice”. Journal of Cellular Biochemistry 12 (2018): 9825-9837.
  21. Sikter A and Sonne C. “Is the Primary Aetiology of Hypertension Unknown? Novel Views on Previous Assumptions”. Acta Scientific Medical Sciences8 (2021): 47-53.
  22. Anderson DE and Brady JV. “Preavoidance blood pressure elevations accompanied by heart rate decreases in the dog”. Science3983 (1971): 595-597.
  23. Anderson DE., et al. "Racial differences in resting end-tidal CO2 and circulating sodium pump inhibitor”. American Journal of Hypertension 14 (2001): 761-767.
  24. Anderson DE., et al. "Capnometric feedback training decreases 24-h blood pressure in hypertensive postmenopausal women”. BMC Cardiovascular Disorder1 (2021): 447.
  25. Rosskopf D., et al. "Membrane sodium-proton exchange and primary hypertension”. Hypertension 21 (1993): 607-617.
  26. Chipperfield AR and Harper AA. “Chloride in smooth muscle”. Progress in Biophysics and Molecular Biology 3-5 (2006): 175-221.
  27. Schwartz WB., et al. "Effects of chronic hypercapnia on electrolyte and acid-base equilibrium. II. Recovery, with special reference to the influence of chloride intake”. Journal of Clinical Investigation7 (1961): 1238-1249.
  28. Grollman A., et al. "Sodium restriction in the diet for hypertension”. JAMA8 (1945): 533-537.
  29. McCallum L., et al. "The hidden hand of chloride in hypertension”. Pflugers Arch3 (2015): 595-603.
  30. Rosendorff C. “The renin-angiotensin system and vascular hypertrophy”. JACC4 (1996): 803-812.
  31. Ghike SM. “Metabolic syndrome - A truly psychosomatic disorder? A global hypothesis”. Medical Hypotheses 97 (2016): 46-53.
  32. Santos MA., et al. "Emotional stress evaluation of patients with moderate and severe sleep apnea syndrome”. International Archives of Otorhinolaryngology 1 (2017): 28-32.
  33. Resnick LM., et al. "Intracellular pH in human and experimental hypertension”. Proceedings of the National Academy of Sciences of the United States of America 21 (1987): 7663-7667.
  34. Aryal D., et al. "Chronic metabolic acidosis elicits hypertension via upregulation of intrarenal angiotensin II and induction of oxidative stress”. Antioxidants (Basel)1 (2021): 2.
  35. Frassetto L and Sebastian A. “Age and systemic acid-base equilibrium: analysis of published data”. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences 1 (1996): B91-99.
  36. Adeva MM and Souto G. “Diet-induced metabolic acidosis”. Clinical Nutrition4 (2011): 416-421.
  37. Sikter A and Sonne C. “A new hypothesis on vascular calcification: the exhausting buffer syndrome (EBS)”. Neuropsychopharmacologia Hungarica1 (2021): 215-220.
  38. Wagner CA. “Effect of Mineralocorticoids on Acid-Base Balance”. Nephron Physiology 128 (2014): 26-34.
  39. Zhou Y., et al. "Effects of angiotensin II on the CO2 dependence of HCO3- reabsorption by the rabbit S2 renal proximal tubule”. American Journal of Physiology - Renal Physiology3 (2006): F666-673.
  40. Wakabayashi I., et al. "Intracellular pH as a determinant of vascular smooth muscle function”. Journal of Vascular Research3 (2006): 238-250.
  41. Melamed ML and Raphael KL. “Metabolic Acidosis in CKD: A Review of Recent Findings”. Kidney Medicine2 (2021): 267-277.
  42. Wesson DE. “Is NaHCO3 an antiaging elixir?” American Journal of Physiology - Renal Physiology 311 (2016): F182-F183.
  43. Di Iorio BR., et al. "Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI Study”. Journal of Nephrology6 (2019): 989-1001.
  44. Leibrock CB., et al. "Bicarbonate-sensitive calcification and lifespan of klotho-deficient mice”. American Journal of Physiology - Renal Physiology 310 (2016): F102-F108.
  45. Forni LG., et al. "The Janus faces of bicarbonate therapy in the ICU: not sure!” Intensive Care Medicine3 (2020): 522-524.
  46. Navaneethan SD., et al. "Effects of treatment of metabolic acidosis in CKD: A systematic review and meta-analysis”. Clinical Journal of the American Society of Nephrology 7 (2019): 1011-1020.
  47. Neubauer B., et al. "Angiotensin II short-loop feedback: Is there a role of Ang II for the regulation of the renin system in vivo?” Hypertension 71 (2018): 1075-1082.
  48. Meyer DJ., et al. "Na/K pump mutations associated with primary hyperaldosteronism cause loss of function”. Biochemistry13 (2019): 1774-1785.
  49. Jean-Louis G., et al. "Cardiovascular disease risk reduction with sleep apnea treatment”. Expert Review of Cardiovascular Therapy 7 (2010): 995-1005.
  50. Iftikhar IH., et al. "Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis”. Journal of Hypertens12 (2014): 2341-2350.

Citation

Citation: András Sikter. “Hypertension and the Interior Ion-milieu. Can we Overcome Hypertension with Regulated Breathing?”.Acta Scientific Medical Sciences 6.5 (2022): 155-164.

Copyright

Copyright: © 2022 András Sikter. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In





Contact US