Cited by 232Blood Pressure and Hypertension StudiesRenin-Angiotensin System StudiesSodium Intake and Health

Hypertension: Physiology and Pathophysiology

Hall, John E., Granger, Joey P., do Carmo, Jussara M., da Silva, Alexandre A., Dubinion, John, George, Eric, Hamza, Shereen, Speed, Joshua +1 more·2012·Comprehensive Physiology

Abstract

Despite major advances in understanding the pathophysiology of hypertension and availability of effective and safe antihypertensive drugs, suboptimal blood pressure (BP) control is still the most important risk factor for cardiovascular mortality and is globally responsible for more than 7 million deaths annually. Short‐term and long‐term BP regulation involve the integrated actions of multiple cardiovascular, renal, neural, endocrine, and local tissue control systems. Clinical and experimental observations strongly support a central role for the kidneys in the long‐term regulation of BP, and abnormal renal‐pressure natriuresis is present in all forms of chronic hypertension. Impaired renal‐pressure natriuresis and chronic hypertension can be caused by intrarenal or extrarenal factors that reduce glomerular filtration rate or increase renal tubular reabsorption of salt and water; these factors include excessive activation of the renin‐angiotensin‐aldosterone and sympathetic nervous systems, increased formation of reactive oxygen species, endothelin, and inflammatory cytokines, or decreased synthesis of nitric oxide and various natriuretic factors. In human primary (essential) hypertension, the precise causes of impaired renal function are not completely understood, although excessive weight gain and dietary factors appear to play a major role since hypertension is rare in nonobese hunter‐gathers living in nonindustrialized societies. Recent advances in genetics offer opportunities to discover gene‐environment interactions that may also contribute to hypertension, although success thus far has been limited mainly to identification of rare monogenic forms of hypertension. © 2012 American Physiological Society.Compr Physiol 2:2393‐2442, 2012.

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Crossref · 10.1002/cphy.c110058

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Authors
Hall, J. E., Granger, J. P., do Carmo, J. M., da Silva, A. A., Dubinion, J., George, E., Hamza, S., Speed, J., & Hall, M. E.
Affiliations
University of Mississippi Medical Center (US)
Venue
Comprehensive Physiology
Publisher
Wiley
Published
2012-10
Volume
2
Issue
4
Pages
2393-2442
ISSN
2040-4603 (ISSN-L)
OpenAlex
W1666369702
Cited by
232
References
280
Citations by year
2026: 5 · 2025: 9 · 2024: 11 · 2023: 15 · 2022: 19 · 2021: 20 · 2020: 21 · 2019: 22 · 2018: 14 · 2017: 23 · 2016: 24 · 2015: 27 · 2014: 17 · 2013: 4 · 2012: 1
Type
other
Language
en
Open access
closed
Locations
  • Comprehensive physiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (P01HL051971)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords
hypertension, blood pressure regulation, chronic hypertension, renin-angiotensin-aldosterone system, sympathetic nervous system, endothelin, reactive oxygen species, nitric oxide, natriuretic factor, glomerular filtration rate, sodium reabsorption, essential hypertension, obesity, gene-environment interaction, monogenic hypertension, cardiovascular mortality
MeSH terms
Blood Pressure, Female, Glomerular Filtration Rate, Humans, Hypertension, Kidney, Male, Natriuresis, Obesity, Renin-Angiotensin System, Sex Characteristics, Weight Gain, Genetic Predisposition to Disease, Feedback, Physiological, Extracellular Fluid, Gene-Environment Interaction

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