Pathophysiology of essential hypertension: an update.

Pathophysiology of essential hypertension: an update. Expert Rev Cardiovasc Ther. 2018 Oct 25;: Authors: Saxena T, Ali AO, Saxena M Abstract INTRODUCTION: Hypertension is caused by increased cardiac output and/or increased peripheral resistance. Areas covered: The various mechanisms affecting cardiac output/peripheral resistance involved in development of essential hypertension are covered. These include Genetics, Sympathetic nervous system over activity, Renal mechanisms: Excess sodium intake and pressure natriuresis, Vascular mechanisms: Endothelial cell dysfunction and the Nitric Oxide Pathway, Hormonal Mechanisms: The renin-Angiotensin-Aldosterone system(RAAS), Obesity, Obstructive Sleep Apnea (OSA), Insulin resistance and metabolic syndrome, Uric Acid, Vitamin D, Gender Differences, Racial, Ethnic and Environmental Factors. Increased Left ventricular ejection force and hypertension and its association with- increased basal sympathetic activity- Cortical connections. Expert commentary: Maximum association of hypertension is found with sympathetic over-activity which is directly or indirectly involved in different mechanisms of hypertension including RAS, OSA, obesity etc. It is not overt sympathetic activity; but disturbed basal sympathetic tone. Basal sympathetic tone arises from hypothalamus; possibly affected by cortical influences. Therefore, hypertension is not merely a disease of circulatory system alone. Its pathogenesis i...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research