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Pathophysiology and Pharmacotherapy of Cardiovascular Disease pp 655–683Cite as

Pathophysiology of Hypertension

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Abstract

Hypertension is a rather simple phenotype characterized by an increase in systemic blood pressure above an arbitrarily defined threshold. Yet, the mechanisms leading to the increase in blood pressure are extremely complex and involved a wide variety of neurohormonal, renal, metabolic, and vascular factors. The causes of hypertension differ substantially in young children, in middle-aged men and women, and in the elderly. In children, hypertension is often the appearance of a renal or endocrine disease, whereas in adults, the large majority of patients with hypertension have an essential hypertension, a denomination reflecting that the mechanisms are not fully understood although some well-defined pathogenic factors have been described in patients with hypertension associated with diabetes mellitus, obesity, hyperaldosteronism, renovascular hypertension, or renal diseases. In the elderly, hypertension is strongly associated with factors leading to vascular aging and loss of arterial elasticity. The purpose of this chapter is to review the pathophysiology of hypertension in these different clinical situations in light of the recent literature.

Keywords

  • Renal
  • Sodium handling
  • Hormonal systems
  • Inflammation
  • Estrogens
  • Immunity

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Fig. 31.1
Fig. 31.2
Fig. 31.3
Fig. 31.4

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Authors and Affiliations

  1. Service of Nephrology and Hypertension, Department of Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 17, Lausanne, 1011, Switzerland

    Michel Burnier MD & Grégoire Wuerzner MD

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  1. Michel Burnier MD
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  2. Grégoire Wuerzner MD
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Correspondence to Michel Burnier MD .

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Editors and Affiliations

  1. Center for Drug Evaluation and Research Division of Cardiovascular and Renal Products, US Food and Drug Administration, Silver Spring, Maryland, USA

    Gowraganahalli Jagadeesh

  2. Pharmacology Unit, AIMST University, Bedong, Malaysia

    Pitchai Balakumar

  3. Center for Drug Evaluation and Research Division of Cardiovascular and Renal Products, US Food and Drug Administration, Silver Spring, Maryland, USA

    Khin Maung-U

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Burnier, M., Wuerzner, G. (2015). Pathophysiology of Hypertension. In: Jagadeesh, G., Balakumar, P., Maung-U, K. (eds) Pathophysiology and Pharmacotherapy of Cardiovascular Disease. Adis, Cham. https://doi.org/10.1007/978-3-319-15961-4_31

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