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The Renin-Angiotensin System and Blood Pressure-you need a more creative title Deep under that skin of yours-that skin of yours? First, no personal pronouns. Second, this is the most important sentence of your paper. It should tell the reader exactly where this paper is going. So if your paper is not about arteries under your skin, then it must be changed. there are arteries. General to specific. What is blood pressure? How is it regulated? This is as general as you can get and therefore this is where you start. The blood in the arteries builds up pressure along its walls.-too specific already. What about the heart? The heart is where the force comes from. This pressure calculation is called blood pressure.-say what? Is that necessary. Just say BP is the pushing of the blood on the artery walls. Hypertension You did not transition into this sentence. You just jumped. First, what is hypertension? How does this sentence relate to the previous one? Every sentence fits together like the pieces of a puzzle. is the most common of all chronic diseases; it’s characterized as having a higher amount of pressure in the arteries.-higher amount than what? This affects about twenty-four million people in America.-This is the general info. This should be what you lead off with. What is hypertension, who does it affect, how many, etc… Anything that is higher then a reading of 120/80 mmHg is considered to be hypertension.-You need to explain what these numbers mean. What does the reader need to know and when do they need to know it? That is what you need to be asking yourself. Hypertension increases ones risks for kidney damage, heart disease, and stroke (Marx I. J., 1976).-why? Can you-no personal pronouns imagine that there are many things that are proven proven? to affect hypertension, yet physicians are not looking into most of them?-this sentence needs to go. Just get to the point. Many of these things-don’t say “things”. exist in the renin-angiotensin-aldosterone system.-this sentence is vague. It doesn’t give the reader any new information. This system affects the width of the blood vessels and the amount of blood in the blood stream.-You need to explain the system. The entire system step by step for my grandma. This is just one possible cause.cause of what? To test for the cause of hypertension, common tests –repeated “test” are done first, none of which test the renin-angiotensin system.-Basically what your saying is that hypertension might be caused by the RA system, but doctors do not typically test this system when looking for the cause? You have a lot of work to do. I am going to stop here. You need to take my suggestions and go through this entire manuscript and fix it. The order needs to be appropriate, must be general to specific, there must be proper transitions, etc… You need to write for the reader, the general audience. Describe using analogies and relate it to what the reader already knows. 4/10 Hypertension is usually greeted by a few common tests and changes in lifestyle. These tests mostly test the heart and the kidneys, by means of blood tests, urine tests, and sonograms. The first test that will usually be done as a simple broad blood test. This test tests for things like sodium and potassium level abnormalities; it will also test for creatine, cholesterol, HDL, and LDL. If one of these comeback abnormal a medicine will be prescribed to make the level normal and then further tests will be taken to find out why this level is different (Marx, I. J. 1976). The next test will most likely be an echocardiogram, which is a sonogram of the heart. A kidney sonogram will follow that. These to tests check to make sure the heart and the kidneys are functioning in the proper way and are the proper size. After that, the doctor will most likely give up and leave the patient on medicine. A physician will also talk to a patient about eating habits. Salt is suggested to increase blood pressure (Whitescarver, A. S., Ott, E. C., Jackson, A. B., Guthrie, P. G., & Kotchen, A. T., 1984). This is one of the hardest areas to control, for salt is very prominent in most manufactured foods. Red meat is also suggested to increase blood pressure (Tzoulaki et al., 2008). Red meat and salt are two dietary areas that are heavy in American society, getting rid of those, based on previous studies, should lower the blood pressure. The renin-aniotensin-aldosterone system works, to control blood pressure, with the help of two main enzymes and one main hormone. The enzymes are renin and angiotensin, the hormone is aldosterone. The first thing that happens in this system is that angiotensinogen is released by the liver, this is inactive angiotensin. After that occurs renin is added by the kidney. Renin is the enzyme that activates the angiotensinogen (Lifton, 1996). The higher the amount of renin, the higher the amount of the following chemicals (Takimoto et al., 1996). After renin, ACE, angiotensin-converting-enzyme is added to activate the angiotensin into the working phase, this new angiotensin is called angiotensin II. We now have the completed product of angiotensin II (Santos et al., 2003). Angiotensin has three main functions: it can constrict blood vessels, make more water enter the blood, and/or make the kidney release aldosterone. Constricting the blood vessels is a fairly simple concept. Blood vessels are like hoses. If you have two hoses with different diameters, but the same amount of water, you would be able to tell that the smaller the diameter of the hose, the higher the pressure. The body uses this concept, with angiotensin II, to increase the blood pressure. Increasing the volume of the blood will also increase the blood pressure. Say you had the same hose that you previously had in the prior scenario. If the larger diameter has more water added to it, the pressure will increase. Angiotensin II does this in the body with the use of the pituitary gland and the kidney. The pituitary gland releases ADH. ADH stimulates the kidney to absorb more water to put into the blood. This increase of water in the blood will cause the volume to increase, therefore making the blood pressure go up. Angiotensin II also causes the release of a steroid hormone called aldosterone. Aldosterone is secreted by the kidney. This hormone does things to aid the previous two things. Aldosterone leads to the absorption of water, but it also leads to the absorption of more sodium. Aldosterones function, which can be felt by someone with abnormal amounts, is that it triggers ones appetite for salt, which triggers the feeling of thirst. This is a fairly common abnormality among blood pressure patients (Rayner, 2007). Twelve to thirteen percent of all hypertensive patients have primary aldosteronism, which is increased aldosterone. The renin-angiotensin system can be altered with medication in several different ways. If the angiotensin level, is what needs to be altered, an ACE inhibitor can be used. Ace stands for angiotensin-converting-enzyme inhibitor. This doesn’t allow as much active angiotensin be produced (Miller et al., 1972). Tests show that this is affective in mammals with increased blood pressure, due to increased angiotensin. Many doctors just prescribe this to patients instead of doing a simple blood test to see if it is the right medication. Other medications may be used to assist these medications. The angiotensin-renin system alters blood pressure. About 15% of all hypertensive patients have this system to blame (Marx, 1976). It all starts with the amount of angiotensinogen in the blood. If one has a reduced angiotensinogen concentration in the blood, the person will have lower blood pressure (Felix & Michelini, 2007). One main medication is used to treat an imbalanced angiotensin-renin system. This system is a frontline cause in blood pressure increase, yet is not being looked into as a major factor of blood pressure increase. References Felix, C. V. J., & Michelini, C. L. (2007). Training-Induced pressure fall in spontaneously hypertensive rats is associated with reduced angiotensinogen mRNA expression within the nucleus tractus solitarii. Hypertension, 50, 780-785. Lifton, P. R. (1996). Molecular genetics of human blood pressure variation. Science, 272, 676-680. Marx, I. J. (1976). Hypertension: A complex disease with complex causes. Science, 194, 821-825. Miller, M. D., Samuels, A., Haber, E., & Barger, A. C. (1972). Inhibition of angiotensin conversion in experimental renovascular hypertension. Science, 177, 1108-1110. Rayner, B. (2008). Primary aldosteronism and aldosterone-associated hypertension. Journal of Clinical Pathology, 61, 825-831. Santos, S. A. R., Silva, S. C. A, Maric, C., Silva, R. M. D,Machado, P. R., Buhr, D. I., … Walther, T. (2003). Counteracting Hypertension. Science, 100, 569. Takimoto, E., Ishida, J., Sugiyama, F., Horiguchi, H., Murakami, Z., & Fukamizu, A. (1996). Hypertension induced in pregnant mice by placental rennin and maternal angiotensinogen. Science, 274, 995-998. Tzoulaki, I., Brown, J. I., Chan, Q., Horn, V. H., Ueshima, H., Zhao, L., … Elliot, P. (2008). Relation of iron and red meat intake to blood pressure: cross sectional epidemiological study. BMJ, 337, 258. Whitescarver, A. S., Ott, E. C., Jackson, A. B., Guthrie, P. G., & Kotchen, A. T. (1984). Salt-sentive hypertension: Contribution of chloride. Science, 223, 1430-1432.