New Ways to Understand Disease

• Conventional Medical thinking:  HYPERTENSION is seen as an "idiopathic"* disease occurring when a person’s measured blood pressure is higher than desirable [using criteria developed by expert consensus].   (*Idiopathic means no known cause)
• Systems Biology thinking:  HYPERTENSION is understood as one phase of inflammatory vascular disease, resulting from inflammation of the lining of arteries and tightening of smooth muscle within arteries.  This inflammation and tightening results in stiffening and narrowing of the arteries and elevation of the blood pressure.  Systems Biology research points to over-activation of the deep brain as a major causitive factor.
• Thinking about HYPERTENSION through the Trauma-Health Equity-Neurobiology (THEN) lens:  The severity of HYPERTENSION correlates with the severity of trauma and adverse experiences, especially the experience of Everyday Discrimination. 
  For any person, the cause of HYPERTENSION is best understood through reviewing the person’s LIFE COURSE (from childhood to the present).  LGBTQAI+ and Black, Indigenous and Persons of Color (BIPOC) are particularly at risk.

References for RE-THINKING Hypertension:

• Teague et al (2017) Unraveling Vascular Inflammation:  From Immunology to Imaging.
• Rodriguez-Iturbe B et al.  Role of the Immune System in Hypertension. Physiol Rev.  July 2017. 
  Updated understanding of the physiology underlying hypertension:  infiltration of immune cells, oxidative stress, and stimulation of angiotensin system, vascular relaxation, and over-reactivity of sympathetic nervous system.
• Solak Y, Afsar B, Vaziri ND, et al.  Hypertension as an autoimmune and inflammatory disease.  Hypertension Research (2016) Pathophysiology of hypertension with a focus on oxidant stress-autoimmunity-inflammation interaction.

Conventional Medical Thinking:  Asthma is idiopathic (cause unknown), with inflammation, narrowing and spasm of airways. The goal of treatment is to reduce airway inflammation and restore flexible airways.  Treatment uses inhaled corticosteroids, anti-inflammatory meds – and in emergencies, a rescue inhaler, epinephrine and systemic steroids.

Systems Biology Thinking agrees that Asthma is an inflammatory disease but points to over-activation of the deep brain as the instigating factor as well as lack of restorative sleep.

THEN Thinking* - Stressful life events (traumatic experience) has been shown to cause increased reactivity of the airways as well as increased airway inflammation. 
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* THEN Thinking is an integrated approach to understand the onset and course of a Disease Pattern - as occurring within the Brain-Body (rather than a specific organ system), recognizing the impact of Trauma and the Neurobiologic response to trauma - and to evaluate the Health Equity impact. 

* THEN Thinking

RESOURCES:  

Priftis (2009) Dysregulation of the stress response in asthmatic children.  Allergy.  Chronic stress prevents the body from responding to acute events resulting in chronic airway inflammation.