A unifying pathway for essential hypertension

Richard J. Johnson, Bernardo Rodriguez-Iturbe, Duk Hee Kang, Daniel I. Feig, Jaime Herrera-Acosta

Research output: Contribution to journalReview articlepeer-review

133 Scopus citations

Abstract

We present the hypothesis that most cases of essential hypertension occur via two phases. The first phase is initiated by episodes of renal vasoconstriction induced by a hyperactive sympathetic nervous system, activation of the renin-angiotensin system, or hyperuricemia resulting from diet or genetics. During this phase the hypertension is salt resistant and renin dependent, and the kidney normal. Over time, preglomerular vascular disease develops (arteriolosclerosis), associated with tubulointerstitial inflammation; this shifts the hypertension to a salt-sensitive, volume-dependent, and renal-dependent pathway. This pathway unites many of the previous hypotheses on the etiology of hypertension, and offers insights into ways to prevent, ameliorate, or cure the underlying process.

Original languageEnglish
Pages (from-to)431-440
Number of pages10
JournalAmerican Journal of Hypertension
Volume18
Issue number3
DOIs
StatePublished - Mar 2005

Fingerprint

Dive into the research topics of 'A unifying pathway for essential hypertension'. Together they form a unique fingerprint.

Cite this