A physician-scientist at UT Southwestern Medical Center and his research team have identified mechanisms causing a potentially deadly type of hypertension that results from liver damage – findings that could lead to its prevention.
This particular type of hypertension, called portal hypertension, affects the blood flow into the portal vein, which feeds blood to the liver.
Dr. Don Rockey, the new chief of the digestive and liver diseases at UT Southwestern, identified the cellular activity that results in portal hypertension. He and his colleagues then took the research a step further, showing that if the process can be interrupted, the hypertension subsides.
The National Institutes of Health-funded research – available online and scheduled to appear in a future issue of the journal Nature Medicine – was conducted by Dr. Rockey while he was at Duke University Medical Center.
"Portal hypertension is a deadly disease that complicates many forms of chronic liver injury," Dr. Rockey said. "When this occurs, in its most severe form, the prognosis definitely becomes guarded," often leading to the need for a liver transplant.
The short-term mortality for patients with portal hypertension is about 30 percent. The latest research opens new ground scientifically and has implications for possible clinical approaches, said Dr. Rockey.
"The end result of portal hypertension is bleeding and development of ascites [fluid in the abdomen]; so if you could treat it early, you could prevent bleeding and/or the formation of ascites," he said.
Portal hypertension is similar to the widely known essential hypertension, which impairs blood flow to the heart systems. But portal hypertension affects blood flow to the liver-related systems.
The liver is an essential organ that washes the body's blood of wastes and poisons. Cirrhosis of the liver occurs when the cells are damaged. Scarring often results, reducing blood flow into the liver and raising pressure on veins not designed to handle that much blood flow. The high pressure can cause veins to burst, resulting in internal bleeding and potentially death.