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(Hypertension. 2007;49:979.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

To Dip or Not to Dip

Of Arterial Pressure Physiology, System’s Analysis, and Information

Massimo Pagani

From the Centro Ricerca Terapia Neurovegetativa, Dipartimento Scienze Cliniche L Sacco, Universita’ di Milano, Milan, Italy.

Correspondence to Massimo Pagani, Dipartimento Scienze Cliniche, UO Telemedicina, Ospedale L Sacco, Via G B Grassi 74, 20157 Milan, Italy. E-mail mp@ctnv.unimi.it

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In real life, arterial pressure is never at complete rest but is continuously in a state of change. Both in humans and animals, arterial pressure rises during emotional arousal, stress, physical exercise, or the fight–flight reaction; conversely it decreases during periods of rest, relaxation, or sleep. There are several critical points in the study of arterial pressure (dys)regulation, particularly considering clinical applications. Importantly, the cardiovascular system is rarely addressed in its complex entirety, as a coordinated whole. Individual components are frequently singled out and addressed independently from one another. This approach is typically based on the Newtonian deterministic concept that the function of a system composed of multiple components, as is the case with circulation, can be deduced from the linear summation of the functions of the various parts. Disease can be resolved by simply correcting the faulty component.

Recently, several authors have pointed out that a better approach could be furnished by the view, traceable to Aristotle, that, in biology, time and context must be factored in, considering all of the involved components, in a nondeterministic, nonlinear, self-organizing whole. In this system approach, information about interrelations between various components, rather than simple physiology of individual elements, carries a critical importance. Treatment is individualized and directed at optimizing dynamical interrelations between components. Accordingly, simple markers of the system’s performance might be particularly helpful in clinical practice.

This approach could help to better integrate old and new data into hypertension medicine. A case in point is represented by the baroreflex, which . . . [Full Text of this Article]

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