Concept of organ dysfunction revealed by shift in thinking from V = IR to W = VI.

Blood pressure is expressed as V (blood pressure) = I (circulating blood volume or cardiac output) × R (peripheral vascular resistance), based on Ohm's law (V (voltage) = I (current) × R (resistance)). Antihypertensive drugs that reduce either I or R are used. On the other hand, the electrical energy consumed per unit time is power (W), which is expressed as W = VI. If we consider the energy consumed by each organ to be W, and assume that an organ consumes a constant amount of functional bioenergy requirement (FBR), then V and I work in a complementary manner. It is conceivable that if a decrease in blood flow occurs first due to conditions such as arteriosclerosis or peripheral circulatory failure, peripheral blood pressure will rise compensatorily; conversely, if systemic blood pressure rises first, tissue blood flow will decrease compensatorily, potentially leading to chronic ischemia. In this medical hypothesis, I would like to consider a shift in perspective from V = IR to W = VI in blood pressure management-a field that has traditionally focused on peripheral vascular resistance (R)-by shifting the focus to blood pressure regulation aimed at maintaining FBR in tissues. Conventional blood pressure regulation is based on Ohm's law (V = IR), where antihypertensive therapy primarily targets cardiac output (I) or peripheral vascular resistance (R) to reduce blood pressure. We propose a complementary framework based on W = VI, in which blood pressure (V) and tissue perfusion (I) are regulated cooperatively to preserve the functional bioenergy requirement (FBR) of tissues. Reduced tissue perfusion may induce a compensatory blood pressure elevation, whereas primary blood pressure elevation may trigger autoregulatory responses that limit the pressure-driven increase in tissue blood flow, potentially resulting in chronic tissue ischemia. This paradigm highlights a shift from lowering visible blood pressure alone toward preserving the invisible FBR of tissues. This figure was created with the assistance of generative AI (GPT-5.6 Thinking) based on the content of this paper. The authors have verified the content.