What comes first - hypertension or furring?

Presenter - And so what comes first, the furring up of your arteries or the high blood pressure?

Martin - Right, very good question

Presenter - Because I would have thought that one would cause the other or something

Martin - It does, you're absolutely right. Almost always the first is the hypertension, and as I've said before we don't know why that happens, it's just a phenomenon, and you can be 25 and still have hypertension. So that's usually the first thing, but you're right that to a degree the furring up of the arteries then can promote hypertension, partly because – little known fact to those outside the medical profession – but the kidneys are one of the main determinants of your blood pressure

Presenter - Oh I've never heard that before

Martin - Absolutely, so there is this sort of vicious circle thing that you can get where the arteries to your kidneys fur up, your kidneys then think your blood pressure is a bit lower than it is

Presenter - Ah right

Martin - Ok, because you've got this narrowing, your kidneys then think it's a bit too low, I need to crank up the blood pressure. Blood pressure goes even higher, more furring up, that sort of thing. Also hypertension itself can cause kidney damage

Presenter - Oh right

Martin - And that can have a bit of a vicious circle thing

Presenter - So going on to the effects of hypertension then. If you have high blood pressure and you don't know you've got high blood pressure, what effects can that have on you?

Martin - Yes

Presenter - Can it be fatal?

Martin - It can be fatal, I mean going back you know 20 years or so, or perhaps longer, our grandparents era when really hypertension wasn't recognised or blood pressure wasn't really treated, often the first thing you would know about your high blood pressure is you would have a stroke, or a heart attack or die

Presenter - Right. And people died much younger those days didn't they as well --

Martin - That's exactly right

Presenter - You can expect to live into your 80s now don't you?

Martin - Absolutely right and you know, if we talk to our patients and we talk to them about their grandparents or their older parents and you say did they have high blood pressure, often they will sort of shrug their shoulders, don't know, but they died of a heart attack, and you think probably they did