Summary
The level of arterial blood pressure is set by complex interactions of several mechanisms which influence both blood flow in and resistance of the vascular system. An imbalance favouring elevation of vascular resistance or extracellular volume will result in hypertension. Such alterations may include increased activity of the sympathetic nervous system, of the renin-angiotensin system, or excessive secretion of mineralocorticoids. Of equal importance may be a reduced activity of blood pressure-lowering factors such as prostaglandins and the kallikrein-kinin system. This paper describes the possible significance of prostaglandins in the pathophysiology of hypertension and in degenerative vascular disease, based on their involvement in the control of vascular resistance, renal regulation of extracellular volume and plateletvessel wall interactions. An abnormality in the biosynthesis of certain prostaglandin endoperoxide metabolites may lead to hypertension even without an increase in the activity of the classic blood-pressure-elevating systems. The contribution of prostaglandins for the development of hypertension and degenerative vascular disease may be based on an inherent abnormality of the prostaglandin system, as well as on the effects of major risk factors such as dietary intake of sodium and fat on prostaglandin synthesis. Specific blockade or stimulation of distinct biosynthetic pathways leading to antagonistically acting prostaglandins and nutritional manipulation of precursor fatty acids should lead to a better understanding of the pathomechanisms involved and may offer new strategies for therapy or prevention of these cardiovascular disorders.
Zusammenfassung
Die Blutdruckhöhe wird durch komplexe Wechselwirkungen verschiedener Mechanismen bestimmt, die sowohl den Blutfluß als auch den Widerstand des Gefäßsystems beeinflussen. Ein Übergewicht der Faktoren, die den Gefäßwiderstand oder das Extrazellulärvolumen vergrößern, führt zu einem Anstieg des Blutdrucks. Solch ein Ungleichgewicht kann z.B. durch eine erhöhte Aktivität des sympathischen Nervensystems und des Renin-Angiotensin-Systems oder durch eine gesteigerte Mineralocorticoid-Sekretion verursacht sein. Ebenso könnte eine verminderte Aktivität blutdrucksenkender Faktoren wie der Prostaglandine oder des Kallikrein-Kinin-Systems zu einem Anstieg des Blutdrucks führen. In dieser Arbeit wird die mögliche Rolle der Prostaglandine für die Pathophysiologie der essentiellen Hypertonie und degenerativer Gefäßerkrankungen dargestellt, basierend auf der Beteiligung von Prostaglandinen an der Kontrolle des Gefäßwiderstandes, der renalen Regulation des Extrazellulärvolumens und der Thrombozyten-Gefäßwand-Wechselwirkung. Ein Ungleichgewicht der Synthese bestimmter Prostaglandin-Endoperoxid-Metabolite könnte zur Hochdruckentstehung beitragen, auch ohne Vorliegen einer erhöhten Aktivität der bekannten blutdrucksteigernden Faktoren. Dabei könnte die Beteiligung der Prostaglandine an der Entstehung von Hochdruck und degenerativer Gefäßerkrankung sowohl auf einer primären Abnormalität beruhen als auch in einer Mittlerrolle für bekannte Risikofaktoren wie hohe Kochsalz-und Fettzufuhr bestehen. Spezifische Blockade oder Stimulation bestimmter Biosynthesewege, die zu gegensätzlich wirksamen Prostaglandinen führen, oder Änderung der nutritiven Zufuhr von Prekursor-Fettsäuren sollte zu einem besseren Verständnis zugrunde liegender Pathomechanismen und zu neuen Ansatzpunkten für Therapie oder Prävention dieser Herz-Kreislauferkrankungen führen.
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Dedicated to Professor E. Buchborn on the occasion of his 60th birthday
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Weber, P.C., Siess, W., Scherer, B. et al. Arachidonic acid metabolites, hypertension and arteriosclerosis. Klin Wochenschr 60, 479–488 (1982). https://doi.org/10.1007/BF01756093
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DOI: https://doi.org/10.1007/BF01756093