Pathogenesis of Hypertension: Vascular Mechanisms
The mechanisms involved in the pathogenesis of hypertension are increasingly well understood. The focus classically has been on neural and humoral stimuli of vascular constriction and on endocrine and renal stimuli that control blood volume. It has become clear that strong environmental and genetic influences converge to result in the hypertensive phenotype . With the development of the science of vascular biology in recent years there has been increasing focus on the blood vessel wall itself in the pathogenesis of hypertension. The present view is that the resistance arteriole may be involved in the pathogenesis of the disease, both primarily and secondarily Hemodynamic, neural, and humoral factors or mechanisms intrinsic to the vessel wall itself may initiate contractile or structural changes that result in initial increases in pressure. The adaptive changes in the arteriole in response to an elevated intravascular pressure perpetuate and probably worsen the hypertension. Significant new insights have been developed into both functional and structural changes that may contribute to the initiation and /or progression of this condition.
KeywordsVascular Smooth Muscle Cell Essential Hypertension Vascular Mechanism Essential Hypertensive Patient Exchanger Activity
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