T he hallmark of hypertension is an increase in peripheral vascular resistance. 1 This increase is considered to be related to an increase in tone of resistance arteries as well as to structural changes (i.e., vascular remodeling) of these blood vessels. Accordingly, hypertension research has focused on identifying the mediator or mediators responsible for this phenomenon. Although several possible candidates have been extensively studied, in particular the renin-angiotensin system and catecholamines, no definite answer has been found. Hence, the search for additional mediators or the mediator causing the increase in peripheral vascular resistance in hypertension continues.In addition to the increase in peripheral vascular resistance, hypertension is associated with cardiovascular complications such as myocardial infarction and stroke. In both syndromes, severe ischemia to these vital organs is responsible for the clinical syndrome. Again, structural and functional alterations of the supplying circulation are held responsible. In contrast to the increase in peripheral vascular resistance, however, these changes are primarily seen in certain (i.e., coronary and cerebral) vascular beds rather than in the entire circulation.The question of whether endothelin is involved in hypertension, its complications, or both cannot be solved at this point; however, several aspects can be addressed.
Can Endothelin Induce Hypertension?When infused intravenously, endothelin causes a rapid and transient vasodilation followed by a profound and long-lasting increase in blood pressure.2 " 4 This increase in blood pressure is dose dependent, occurs at much lower concentrations than with any other vasoconstrictor hormone, and also is remarkably long-lasting. In vitro experiments have demonstrated that this increase in blood pressure is related to profound vasoconstriction of resistance arteries of different vascular beds of the circulation.
-6 Although the vasodilator effects of endothelin are related to activation of endothelin B-receptors 7 -8 linked to the formation of prosta-