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Although it is now possible to bring most high blood pressure under

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Although it is now possible to bring most high blood pressure under  [#permalink]

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New post 19 Nov 2019, 09:51
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New Project RC Butler 2019 - Practice 2 RC Passages Everyday
Passage # 461, Date: 19-Nov-2019
This post is a part of New Project RC Butler 2019. Click here for Details


Although it is now possible to bring most high blood pressure under control, the causes of essential hypertension remain elusive. Understanding how hypertension begins is at least partly a problem of understanding when in life it begins, and this may be very early—perhaps within the first few months of life. Since the beginning of the century, physicians have been aware that hypertension may run in families, but before the 1970s, studies of the familial aggregation of blood pressure treated only populations 15 years of age or older. Few studies were attempted in younger persons because of a prevailing notion that blood pressures in this age group were difficult to measure and unreliable and because essential hypertension was widely regarded as a disease of adults.

In 1971, a study of 700 children, ages 2 to 14, used a special blood pressure recorder which minimizes observer error and allows for standardization of blood pressure readings. Before then, it had been well established that the blood pressure of adults aggregates familially, that is, the similarities between the blood pressure of an individual and his siblings are generally too great to be explained by chance. The 1971 study showed that familial clustering was measurable in children as well, suggesting that factors responsible for essential hypertension are acquired in childhood. Additional epidemiological studies demonstrated a clear tendency for the children to retain the same blood pressure patterns, relative to their peers, four years later. Thus, a child with blood pressure higher or lower than the norm would tend to remain higher or lower with increasing age.

Meanwhile, other investigators uncovered a complex of physiologic roles— including blood pressure—for a vasoactive system called the kallikreinkininsystem. Kallikreins are enzymes in the kidney and blood plasma which act on precursors called kininogens to produce vasoactive peptides called kinins. Several different kinins are produced, at least three of which are (powerful blood vessel dilators. Apparently, the kallikrein-kinin system normally tends to offset the elevations in arterial pressure that result from the secretion of salt-conserving hormones such as aldosterone on the one hand and from activation of the sympathetic nervous system (which tends to constrict blood vessels) on the other hand.

It is also known that urinary kallikrein excretion is abnormally low in subjects with essential hypertension. Levels of urinary kallikrein in children are inversely related to the diastolic blood pressures of both children and their mothers. Children with the lowest kallikrein levels are found in the families with the highest blood pressures. In addition, black children tend to show somewhat lower urinary kallikrein levels than white children, and blacks are more likely to have high blood pressure. There is a great deal to be learned about the biochemistry and physiologic roles of the kallikrein-kinin system. But there is the possibility that essential hypertension will prove to have biochemical precursors.

Spoiler: :: OA
B

1. The author is primarily concerned with

(A) questioning the assumption behind certain experiments involving children under the age of 15
(B) describing the new scientific findings about high blood pressure and suggesting some implications
(C) describing two different methods for studying the causes of high blood pressure
(D) revealing a discrepancy between the findings of epidemiological studies and laboratory studies on essential hypertension
(E) arguing that high blood pressure may be influenced by familial factors


Spoiler: :: OA
D

2. Which of the following is mentioned as a factor that initially discouraged the study of hypertension in children?

(A) An expectation that high blood pressure in children was untreatable
(B) Repeated unsuccessful attempts to treat hypertension in adults
(C) The belief that blood pressure in adults aggregates familially
(D) The belief that it was difficult or impossible to measure accurately blood pressures in children
(E) Ignorance of important differences in the physical constitution of ethnic subgroups


Spoiler: :: OA
C

3. The argument in the passage leads most naturally to which of the following conclusions?

(A) A low output of urinary kallikrein is a likely cause of high blood pressure in children.
(B) The kallikrein-kinin system plays an important role in the regulation of blood pressure.
(C) Essential hypertension may have biochemical precursors that may be useful predictors in children.
(D) The failure of the body to produce sufficient amounts of kinins is the cause of essential hypertension.
(E) It is now possible to predict high blood pressure by using familial aggregations and urinary kallikrein measurement.


Spoiler: :: OA
A

4. The author refers to the somewhat lower urinary kallikrein levels in black children (Text In Red) in order to

(A) support the thesis that kallikrein levels are inversely related to blood pressure
(B) highlight the special health problems involved in treating populations with high concentrations of black children
(C) offer a causal explanation for the difference in urinary kallikrein levels between black and white children
(D) suggest that further study needs to be done on the problem of high blood pressure among black adults
(E) prove that hypertension can be treated if those persons likely to have high blood pressure can be found


Spoiler: :: OA
B

5. The author states that the kallikreinkinin system may affect blood pressure by

(A) directly opposing the tendency of the sympathetic nervous system to constrict blood vessels
(B) producing kinins, which tend to dilate blood vessels
(C) suppressing the production of hormones such as aldosterone
(D) controlling the levels of kallikrein in the urine
(E) compensating for cross-subgroup differentials


Spoiler: :: OA
C

6. The evidence that a child with blood pressure higher or lower than the norm would tend to retain the same blood pressure pattern with increasing age (Text In Blue) is introduced by the author in order to

(A) suggest that essential hypertension may have biochemical causes
(B) show that high blood pressure can be detected in children under the age of 15
(C) provide evidence that factors affecting blood pressure are already present in children
(D) propose that increased screening of children for high blood pressure should be undertaken
(E) refute arguments that blood pressure in children cannot be measured reliably


Spoiler: :: OA
C

7. The author’s argument is presented primarily by

(A) contrasting two methods of doing scientific research
(B) providing experimental evidence against a conclusion
(C) presenting new scientific findings for a conclusion
(D) analyzing a new theory and showing its defects
(E) criticizing scientific research on blood pressure done before 1971



Source: Master GMAT
Difficulty Level: Will be updated after 30+ timers attempts

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Re: Although it is now possible to bring most high blood pressure under  [#permalink]

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New post 22 Nov 2019, 02:53
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Re: Although it is now possible to bring most high blood pressure under   [#permalink] 22 Nov 2019, 02:53
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