Pathophysiology of Hypertension

Abstract

Hypertension is a rather simple phenotype characterized by an increase in systemic blood pressure above an arbitrarily defi ned 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 refl ecting that the mechanisms are not fully understood although some well-defi ned 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.

Twelve-Week Protocatechuic Acid Administration Improves Insulin-Induced and Insulin-Like Growth Factor-1-Induced Vasorelaxation and Antioxidant Activities in Aging Spontaneously Hypertensive Rats

“…In older adults with hypertension, more profound pathological processes may exist to induce CVD. Hypertension leads to reversible cardiac and vascular dysfunction, including cardiac hypertrophy, reduced lumen diameter of arteries, increased vascular smooth muscle cell (VSMC) proliferation, and endothelial dysfunction [2,3,4]. Moreover, in aging heart and vessels, the number of myocardial cells is decreased, cardiac fibrosis is increased, elastic arteries become stiffer, and endothelial function is impaired [5,6].…”

Faktor-faktor yang mempengaruhi kepatuhan menggunakan obat antihipertensi: Cross Sectional Study di Puskesmas Sosial Palembang

“…Terdapat dua faktor utama yanmempengaruhi kontrol tekanan darah pada pengobatan pasien hipertensi yaitu peresepan obat antihipertensi dalam jumlah obat dengan dosis yang memadai dan kepatuhan terhadap terapi [4]. Suatu penelitian melaporkan tingkat kepatuhan pasien hipertensi berada pada tingkat kepatuhan rendah sebesar 18,75 %, tingkat kepatuhan sedang 55,21 % dan tingkat kepatuhan tinggi 26,04 % serta terdapat hubungan antara kepatuhan penggunaan obat dengan keberhasilan terapi pada pasien hipertensi di Rumah Sakit Pusri Palembang [5].…”

“…Memahami faktor yang berkontribusi terhadap ketidakpatuhan bermanfaat dalam mengelola ketidakpatuhan. Dengan tidak adanya obat antihipertensi baru, penting bahwa penyedia layanan kesehatan memfokuskan perhatian pada bagaimana melakukan yang lebih baik dengan obat yang ada [4]. Perlu dilakukan penelitian mengenai faktor -faktor yang mempengaruhi kepatuhan pasien hipertensi dalam menggunakan obat, sehingga pada ini penelitian dilakukan penelitian hubungan faktor -faktor sosiodemografi yaitu usia, jenis kelamin, pendidikan dan pekerjaan, faktor yang berhubungan dengan terapi yaitu jenis terapi dan durasi terapi serta faktor kondisi medis pasien yaitu derajat hipertensi dan ada tidaknya komorbid dengan kepatuhan pasien dalam menggunakan obat…”

Zebrafish Model to Study Angiotensin II-Mediated Pathophysiology

“…In hypertensive conditions, the force of blood against the blood vessel wall is much higher than the physiological condition both during the systolic and diastolic status of the heart [1][2][3]. If left unattended, it can affect multiple organs, resulting in myocardial infarction, stroke, and kidney damage [4][5][6]. A WHO report suggests that hypertension contributes to around 50% of the mortality associated with stroke and ischemic heart disease, accounting for about 7.5 million global deaths annually [7].…”