Essential Hypertension – Syndrome, or Compensatory Mechanism
Authors:
I. Hulín; I. Ďuriš; E. Sapáková; Ľ. Paulis; B. Mravec
Authors‘ workplace:
Ústav experimentálnej endokrinológie SAV, Bratislava, Slovenská republika
; I. interná klinika FN a LF UK, Bratislava, Slovenská republika
; Ústav patologickej fyziológie LF UK, Bratislava, Slovenská republika
Published in:
Čas. Lék. čes. 2008; 147: 14-24
Category:
Review Article
Overview
Diagnosis of essential hypertension is created per exclusionem – with exclusion of all, so called secondary hypertensions (nephrogenic, endocrine conditioned etc). Idea and the name-essential hypertension are unclear. We have a lot of hypotheses about mechanisms of hypertension but no one is explaining satisfactorily the „fixation“ of hypertension. From this point of view essential hypertension looks more like a syndrome than disease sui generis. Authors analyzed all possible pathways of hypertension origin as well as compensatory mechanisms in peripheral circulation in effort to reach relevant tissue perfusion. If these mechanisms lead to salt and water retention the best mode of the treatment would be to influence volume and blood vessels lumen. It is clear that optimization of blood pressure is advantageous for prevention of vascular catastrophes (myocardial and cerebral infarction). Nevertheless inadequate lowering of the peripheral tissue perfusion (kidney, CNS) can lead to degenerative changes in tissues and to disturbances in centrally regulated processes of blood pressure.
Key words:
beneficial hypertension, holistic view, capillary flow, kidney, sodium, stress, sympathetic nervous system.
Sources
1. Weder, A. B.: Evolution and hypertension. Hypertension 2007, 49, s. 260–265.
2. Kaplan, N. M.: Clinical trials for hypertension: expectations fulfilled and unfulfilled. Hypertension, 2007, 49, s. 257–259.
3. Vimo, A., Winblad, B., Angero-Torres, H., von Strauss, E.: The magnitude of dementia occurrence in the world. Alzheimer Dis. Assoc. Disord., 2003, 17, s. 63–67.
4. Staessen, J. A., Richart, T., Birkenhäger, V. H.: Less atherosclerosis and lower blood pressure for a meaningful life perspective with more brain. Hypertension, 2007, 49, s. 384–400.
5. Huang, B. S., Amin, M. S., Leenen, F. H.: The central role of the brain in salt-sensitive hypertension. Curr. Opin. Cardiol., 2006, 21, s. 295–304.
6. Leenen, F. H., Ruzicka, M., Huang, B. S.: The brain and salt-sensitive hypertension. Curr. Hypertens. Rep., 2002, 4, s. 129–135.
7. Gardner, D. G., Chen, S., Glenn, D. J., Grigsby, C. L.: Molecular biology of the natriuretic peptide system: implications for physiology and hypertension. Hypertension, 2007, 49, s. 419–426.
8. Thrasher, T. N.: Baroreceptors, baroreceptor unloading, and the long-term control of blood pressure. Am. J. Physiol. Regul. Integr. Comp. Physiol., 2005, 288, s. 819–827.
9. Osborn, J. W.: Hypothesis: set-points and long-term control of arterial pressure. A theoretical argument for a long-term arterial pressure control system in the brain rather than the kidney. Clin. Exp. Pharmacol. Physiol., 2005, 32, s. 384–393.
10. Chobanian, A. V.: Prehypertension revisited. Hypertension 2006, 48, s. 812–814.
11. Biaggioni, I.: Sympathetic control of the circulation in hypertension: lessons from autonomic disorders. Curr. Opin. Nephrol. Hypertens., 2003, 12, s. 175–180.
12. Hogarth, A. J., Mavkintosh, A. F., Marz, D. A. S. G.: The effect of gender on the sympathetic nerve hyperactivity of essential hypertension. J. Hum. Hypertension, 2007, 21, s. 239–245.
13. Ramchandra, R., Barrett, C. J., Malpas, S. C.: Nitric oxide and sympathetic nerve activity in the control of blood pressure. Clin. Exp. Pharmacol. Physiol., 2005, 32, s. 440–446.
14. Hall, J. E.: Hypertension update 2006. Hypertension, 2006, 48, s. 343–346.
15. Baune, B. T., Aljeesh, Y.: The association of psychological stress and health related quality of life among patients with stroke and hypertension in Gaza Strip. Ann. Gen. Psychiatry, 2006, 5, s. 1–8.
16. Vanitallie, T. B.: Stress: a risk factor for serious illness. Metabolism 2002, 51, s. 40–45.
17. Saha, S.: Role of the central nucleus of the amygdala in the control of blood pressure: descending pathways to medullary cardiovascular nuclei. Clin. Exp. Pharmacol. Physiol., 2005, 32, s. 450–456.
18. Lechin, F., van der Dijs, B.: Central nervous system circuitry and peripheral neural sympathetic activity responsible for essential hypertension. Currr. Neurovasc. Res., 2006, 3, s. 307–325.
19. Parker, D. J. P.: Birth weight and hypertension. Hypertension, 2006, 48, s. 357–358.
20. Beilin, L. J., Puddey, I. B.: Alcohol and hypertension: an update. Hypertension, 2006, 47, s. 1035–1038.
21. The WHOQOL Group. Development of the World Health Organization QHOQOL – BREF quality of life assessment. Psychol. Med. 1998, 28, s. 37–50.
22. Marteau, J. B., Zaiou, M., Siest, G., Visvikis-Siest, S.: Genetic determinants of blood pressure regulation. J. Hypertens., 2005, 23, s. 2127–2143.
23. Dickson, M. E., Sigmund, C. D.: Genetic basis of hypertension. Hypertension, 2006, 48, s. 14–20.
24. Lalouel, J. M., Rohrwasser, A.: Genetic susceptibility to essential hypertension. Insight from angiotensinogen. Hypertension, 2007, 49, s. 597–603.
25. Burchlé, C., Bader, M.: Prorenin and its ancient receptor. Hypertension, 2006, 48, s. 549–551.
26. Feihl, F., Liaudet, L., Waeber, B., Levy, B. I.: Hypertension. A disease of the microcirculation. Hypertension, 2006, 48, s. 1012–1017.
27. Jeong, J. H., Sugii, Y., Minamiyama, M., Okamoto, K.: Measurement of RBC deformation and velocity in capillaries in vivo. Microvasc. Research, 2006, 71, s. 212–217.
28. Williams, D. A.: Change in shear stress (∆@)/hydraulic conductivity (Lp) relationship after pronase treatment of individual capillaries in situ. Microvasc. Research, 2007, 73, s. 48–57.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
Most read in this issue
- Essential Hypertension – Syndrome, or Compensatory Mechanism
- Preoperative Preparation and Examinations Before Scheduled Cardiosurgical Intervention
- Psychomotor Speed and Speed of Searching in Semantic Memory
- Clinical Utility of Bone Markers in the Evaluation and Follow-up in Patients with Neoplastic Bone Diseases