Role of Endothelium in Hypertension

  • Ellis R. Levin
Part of the Current Clinical Practice book series (CCP)


The endothelial lining of blood vessels is the one-cell-thick innermost layer and comprises endothelial cells. The endothelium plays an important role in the dynamic regulation of blood pressure (BP) (Fig. 9-1). Through hormones, cytokines, and other vasoactive factors, the endothelium communicates to and regulates the function of vascular smooth muscle tone. This is critical to the dynamic equilibrium of basal BP, and our understanding of how the body rapidly adjusts to changes in position or blood volume. Abnormalities of the endothelium are reflected in altered basal control of BP, and clearly contribute to the development of hypertension. In this chapter, I explore the important endothelial participants in BP control and suggest ways to modify these factors to yield normotension.


Vascular Smooth Muscle Cell Natriuretic Peptide Brain Natriuretic Peptide Atrial Natriuretic Peptide Primary Pulmonary Hypertension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Yanagisawa M, Kurihara H, Kimura S, et al. (1988) A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 332: 411–415.PubMedCrossRefGoogle Scholar
  2. 2.
    Haynes WG, Webb DJ (1994) Contribution of endogenous generation of endothelin-1 to basal vascular tone. Lancet 344: 852–854.PubMedCrossRefGoogle Scholar
  3. 3.
    Krum H, Viskoper RJ, Lacourciere Y, Budde M, Charlon V (1998) The effect of an endothelin-receptor antagonist, bosentan, on blood pressure in patients with essential hypertension. Bosentan Hypertension Investigators. N Engl J Med, 338 (12): 784–790.PubMedCrossRefGoogle Scholar
  4. 4.
    Giaid A, Yanagisawa M, Langleben D, Michel RP, Levy R, Shennib H, Kimura S, Masaki T, Duguid WP, Stewart DJ (1993) Expression of endothelin-1 in the lungs of patients with primary pulmonary hypertension. New Engl J Med 328: 1732–1739.PubMedCrossRefGoogle Scholar
  5. 5.
    Lanese DM, Conger JD (1993) Effects of endothelin receptor antagonist on cyclosporine-induced vasoconstriction in isolated rat renal arterioles. J Clin Invest 93: 2144–2149.CrossRefGoogle Scholar
  6. 6.
    Fogo A, Hellings SE, Inagami T, Kon V (1992) Endothelin receptor antagonism is protective in in vivo acute cyclosporine toxicity. Kidney Int 42: 770–774.PubMedCrossRefGoogle Scholar
  7. 7.
    Corvol P, Soubrier F, Jeunemaitre X (1997) Molecular genetics of the reninangiotensin-aldosterone system in human hypertension. Pathologie Biologie 45 (3): 229–239.PubMedGoogle Scholar
  8. 8.
    Bravo EL, Gifford RW Jr (1993) Pheochromocytoma. Endocrinol Metab Clin North Am 22 (2): 329–341.Google Scholar
  9. 9.
    John SWM, Veress AT, Honrath U, et al. (1996) Blood pressure and fluid-electrolyte balance in mice with reduced or absent atrial natriuretic peptide. Am J Physiol 271: R109–R114.PubMedGoogle Scholar
  10. 10.
    Kishimoto I, Dubois SK, Garbers DL (1996) The heart communicates with the kidney exclusively through the guanylyl cyclase-A receptor: acute handling of sodium and water in response to volume expansion. Proc Natl Acad Sci USA 93: 6215–6219.PubMedCrossRefGoogle Scholar
  11. 11.
    Hunt PJ, Espiner EA, Nichols MG, Richards AM, Yandle TG (1996) Differing biological effects of equimolar atrial and brain natriuretic peptide infusions in normal man. J Clin Endocrinol Metab 81: 3871–3876.PubMedCrossRefGoogle Scholar
  12. 12.
    Burnett JC Jr, Kao PC, Hu DC, et al. (1986) Atrial natriuretic peptide elevation in congestive heart failure in the human. Science 231: 1145–1147.PubMedCrossRefGoogle Scholar
  13. 13.
    Ignarro LJ (1993) Nitric oxide-mediated vasorelaxation. Thromb Haemost 70 (1): 148–151.PubMedGoogle Scholar
  14. 14.
    Maccario M, Oleandri SE, Procopio M, Grottoli S, Avogadri E, Camanni F, Ghigo E (1997) Comparison among the effects of arginine, a nitric oxide precursor, isosorbide dinitrate and molsidomine, two nitric oxide donors, on hormonal secretions and blood pressure in man. J Endocrinol Invest 20 (8): 488–492.PubMedGoogle Scholar
  15. 15.
    Baron AD (1996) Insulin and the vasculature—old actors, new roles. J Invest Med 44 (8): 406–412.Google Scholar
  16. 16.
    Pieper GM (1998) Review of alterations in endothelial nitric oxide production in diabetes: protective role of arginine on endothelial dysfunction. Hypertension 31 (5): 1047–1060.PubMedCrossRefGoogle Scholar
  17. 17.
    Penno G, Chaturvedi N, Talmud PJ, Cotroneo P, Manto A, Nannipieri M, Luong LA, Fuller JH (1998) Effect of angiotensin-converting enzyme (ACE) gene polymorphism on progression of renal disease and the influence of ACE inhibition in IDDM patients: findings from the EUCLID Randomized Controlled Trial. EURODIAB Controlled Trial of Lisinopril in IDDM. Diabetes 47 (9): 1507–1511.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Ellis R. Levin

There are no affiliations available

Personalised recommendations