The major cause of death in this country is from diseases of the cardiovascular system, and the most common disease is high blood pressure, which causes inadequate circulation to the heart and overwork of the heart muscle. Some types of high blood pressure are due to glandular disorders, and these have specific treatments.

But the most common kind is called essential hypertension. Its cause is unknown. Although the name given to the disease makes it sound as though it is somehow essential to the person and incurable, I do not feel this is necessarily the case.

High blood pressure, or hypertension, is a condition in which the diameter of the blood vessels all over the body is made smaller by contraction of the muscles in the walls of these vessels.

But the elevated pressure does not come on all at once, nor does it simply become elevated and stay permanently high. On different visits to the doctor's office, the patient's blood pressure is sometimes elevated and sometimes not. The elevation of blood pressure occurs with situations of tension in the person's life. It is common for a person's blood pressure to go up when he or she is excited or nervous, and nervousness often occurs upon physical examination.

Many doctors have the patients take their own blood pressure at home, so reliably does it go up under the stress of being in the doctor's office. In fact, one of the first treatments the physician gives for high blood pressure is merely tranquilizer medication. By keeping the person calm, the blood pressure elevations do not occur as frequently, and the high blood pressure has been treated symptomatically.

The patterns that are causing the tension, however, are not eliminated by the tranquilizer. As a result, the contraction of the walls of the blood vessel may begin to recur as learned response patterns cause the tension level to break through the bonds artificially imposed by the tranquilizer. The blood pressure begins peaking more and more often, and the patient is begun on a diuretic, or water pill. One main function of this medication is to remove a certain amount of water from the body. It thus lowers the total volume present in the bloodstream, and through this, along with several other mechanisms, the symptoms of high blood pressure are again erased-for a while.

The blood pressure soon begins to rise once again, and more vigorous methods of controlling it are employed. Drugs may be used that function through their effect on the kidneys or the nervous, vascular, or endocrine system, but the blood pressure often continues to rise.

In some cases the rise in blood pressure continues to the point that severe headaches, brain problems, or kidney problems result. We can imagine the blood having to flow through all of the spastic vessels to reach the various organs of the body. It must then flow back through the veins to the heart to be pumped out again. As the muscles in the walls of the vessels begin to contract, it becomes more and more difficult for the blood to flow through them. Just as when the garden hose is kinked, the output of water decreases, so too is the volume of blood reaching various organs of the body diminished. In order to compensate for this decreased blood flow, the heart must pump harder. If you had to blow up a balloon through a small straw, you would have to blow much harder than someone blowing it through a larger straw in order to keep up with him or her.

This increased work, of course, falls on the heart muscle. The heart muscle is supplied with blood from arteries in its walls. Like all the other vessels in the body, these vessels may also be narrowed and in spasm. When this spasm has been present for a long time, it may become impossible for the vessel to ever again reach its original diameter.