Aetiological and pathogenetic factors of primary arterial hypertension
Abstract
Over the last few decades, vast evidence has emerged, confirming polygenic hereditary nature of arterial hypertension (AH). Reduced renal salt excretion, genetic or acquired due to diseases, ageing, obesity, or other factors, is a key mechanism in AH pathogenesis. AH development should be regarded as a compensatory reaction, aimed at increasing renal salt excretion, normalising circulating blood volume, and maintaining homeostasis.
About the Authors
V. S. Volkov
Tver State Medical Academy. Tver
Russian Federation
Russian Federation
A. P. Tofilo
Tver State Medical Academy. Tver
Russian Federation
Russian Federation
References
1. Lang G.F. Gipertonicheskaya bolezn'. L. Medgiz 1950; 496 s.
2. Fujita T, Katsuyuki A. Salt, Blood Pressure and Kidney. In Kidney and Blood Pressure Regulation. Contrib Nephrol Basel Karger 2004; 143:172.
3. Guyton AC. Kidneys and fluids in pressure regulation. Small volume but large pressure changes 1992; Hypertension: 19(Suppl. 1): 12-8.
4. Guyton AC, Coleman TG, Cowley AW, et al. Arterial pressure regulation: overriding dominance of the kidneys in long-term regulation and in hypertension. Am J of Medicine 1972; 52: 584-94.
5. Kumar & Clark. Clinical Medicine. 6 Edition. Elsevier Inc. 2006. 1365 p.
6. Oxford Textbook of Medicine 4th edition (March 2003): by David A. Warrell (Editor), Timothy M. Cox (Editor), John D. Firth (Editor), Edward J., J R., M.D. Benz. (Editor) By Oxford Press: 3623 r
7. Guyton AC, Hall JE, Lohmeier ThE, et a1. Blood pressure regulation: basis concepts. Fed Proc 1981; 40: 2252-6.
8. Staessen JA, Wang J, Bianchi G, et al. Essential hypertension. Lancet 2003; 361: 1629- 34.
9. Luft FC. Geneticism of essential hypertension. Hypertension 2004; 43: 1155- 61.
10. Benjafield AV, Wang WY, Speirs HJ, et al. Genome-wide scan for hypertension in Sydney Sibships: The GENIHUSS study. Am J Hypertens 2005; 18: 828- 33.
11. Caulfield M, Munroe P, Pembroke J, et al. Genome-wide mapping of human loci for essential hypertension. Lancet 2003; 361: 2118-25.
12. de Lange M, Spector TD, Andrew T. Genome-wide scan for blood pressure suggests linkage to chromosome 11, and replication of loci on 16, 17, and 22. Hypertension 2004; 44: 872-7.
13. Schwartz F, Duka A, Sun F, et al. Mitochondrial genome mutations in hypertensive individuals. Am J Hypertens 2004; 17: 629-35.
14. Bianchi G, Fox U, Di Francesco GF, et al. Blood pressure changes producedby kidney cross-transplantation between spontaneously hypertensive and normotensive rats. Clin Sci Mol Med 1974; 47: 435-48.
15. Rettig R, Folberth C, Strauss H, et al. Hypertension transmitted by kidneys from stroke-prone spontaneously hypertensive rats. Am J Physiol 1989; 257: 197-203.
16. Manunta P, Cerutti R, Bernardi L, et al. Renal genetic mechanisms of essential hypertension. J Nephrol 1997; 10: 172-8.
17. Mein CA, Caulfield MJ, Dobson RJ, et al. Genetics of essential hypertension. Hum Mol Genet 2004; 13 Spec No 1:169-73.
18. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206-11.
19. Marcantoni C, Ma L-J, Federspiel C, Fogo AB. Hypertensive nephrosclerosis in African-Americans vs Caucasians. Kidney Int 2002; 62: 172-80.
20. Fields LE, Burt VL, Cutler JA, et al. The burden of adult hypertension in the United States 1999-2000: A rising tide. Hypertension 2004; 44: 398-403 .
21. Parmer RJ, Stone RA, Cervenka JH. Renal hemodynamics in essential hypertension: Racial differences in response to changes in dietary sodium. Hypertension 1994; 24: 752-7.
22. Rostand SG. Hypertension and renal disease in blacks: Role of genetic and/or environmental factors? Adv Nephrol Necker Hosp 1992; 21: 99-105.
23. Suthanthiran M, Li B, Song JO, et al. Transforming growth factor-beta 1 hyperexpression in African American hypertensives: A novel mediator of hypertension and/or target organ damage. Proc Natl Acad Sci USA 2000; 97: 3479-84.
24. Manalich R, Reyes L, Herrera M, et al. Relationship between weight at birth and the number and size of renal glomeruli in humans: A histomorphometric study. Kidney Int 2000; 58: 770-6.
25. Pharoah POD, Stevenson CJ, West CR. Association of blood pressure in adolescence with birth weight. Arch Dis Child Fetal Neonatal 1998; 79: 114-20.
26. Toto RD. Hypertensive nephrosclerosis in African Americans. Kidney Int 2003; 64: 2331-6.
27. Keller G, Zimmer G, Mall G, et al: Nephron number in patients with primary hypertension. N Engl J Med 2003; 348: 101-8.
28. Harrison’s Prinsiples of Internal Medisine 2008;17-th Edition: 3352 r.
29. Bright, R. Tabular view of the morbid appearances in 100 cases connected with albuminous urine. Guy’s Hospital Reports 1836; 1: 380-400.
30. Cowley AW Jr. Long-term control of arterial blood pressure. Physiol Rev 1992; 72: 231-300.
31. Vander A. Fiziologiya pochek. Per. s angl. i red. akad. Yu.V.Natochina. SPB “Piter” 2000; 252 c.
32. Fujita T, Henry WL, Bartter FC, et al. Factors influencing blood pressure in human subjects with idiopathic hypertension. Am J Med 1980; 69: 334-44.
33. Kawasaki T, Delea CS, Bartter FC, Smith H. The effect of high-sodium and low-sodium intakes on blood pressure and other related variables in human subjects with idiopathic hypertension. Am J Med 1978; 64: 193-8.
34. Contrib Nephrol 2004; Basel: Karger:vol 143:172 p.
35. Laragh JH: Laragh’s lesson in renin system pathophysiology for treating hypertension and its fatal cardiovascular consequences 2002; New York: Elsevier Science: 76 r.
36. Hall JE. The kidney, hypertension, and obesity. Hypertension 2003; 41: 625-33.
37. Hall JE, Mizelle HL, Brands MW, Hildebrand DA. Pressure natriuresis and angiotensin II in reduced kidney mass, salt-induced hypertension. Am J of Physiology 1992; 262: 61-71.
38. Oxford Textbook of Clinical Nephrology, 3rd Edition. Editors: Davison, Alex M.; Cameron, J. Stewart; Grunfeld, Jean-Pierre; Ponticelli, Claudio; Ritz, Eberhard; Winearls, Christopher G.; Ypersele, Charles van Title: Copyright 2005. Oxford University Press. 2643 p.
39. Johnson RJ, Herrera-Acosta J, Schreiner GF, Rodriguez-Iturbe B. Subtle acquired renal injury as a mechanism of salt sensitive hypertension. New Engl J Med 2002; 346: 918-23.
40. Ruilope LM, van Veldhuisen DJ, Ritz E, Luscher TF. Renal function: the Cinderella of cardiovascular risk. JACC 2001; 38: 1782-7.
41. Morimoto A, Uzu T, Fujii T, et al. Sodiumsensitivity and cardiovascular events in patients with essential hypertension. Lancet 1997; 350: 1734-7.
42. Ono A, Kuwaki T, Kumada M, Fujta T. Differential central modulation of the baroreflex by saltloading in normotensive and spontaneously hypertensive rats. Hypertension 1997; 29: 808-14.
43. Fujita T, Sato Y. Hypotensive effect of taurine: Possible involvement of the sympathetic nervoussystem and endogenous opiates. J Clin Invest 1988; 82: 993-7.
44. Fujita T, Sato Y. Role of hypothalamic-renal noradrenergic systems in hypotensive action of potassium. Hypertension 1992; 20: 466-72.
45. Sato Y, Ando K, Ogata E, Fujita T. High potassium intake attenuates antinatriuretic response to airstress in DOCA-salt rats. Am J Physiol 1991; 260: 941-5.
46. Esler MD, Hasking GJ, Willett IR, et al. Noradrenaline release and sympathetic nervous system activity. J Hypertens 1985; 3: 117-29.
47. Hollenberg NK, Williams GH, Adams DF: Essential hypertension: Abnormal renal vascular and endocrine response to a mild psychological stimulus. Hypertension 1981; 3: 11-7.
48. Fujita T, Sato Y. Natriuretic and antihypertensive effects of potassium in DOCA-salt hypertensive rats. Kidney Int 1983; 24: 731-9.
49. Fujta T, Ando K. Hemodynamic and endocrine changes associated with potassium supplementationin sodium-loaded hypertensives. Hypertension 1984; 6: 184-92.
50. Ginzburg M.M., Kozlupitsa G.S. Znachenie raspredeleniya zhira pri ozhirenii. Probl endokrin 1996; 42(3):42-6.
51. Buckland Y. The obesity epidemic. J Fam Health Care 2002; 12(4): 111-7.
52. Labib M. The investigation and management of obesity. J Clin Path 2003; 56: 17-25.
53. Fedorova E.Yu., I.M.Kutyrina. Mekhanizmy progressirovaniya porazheniya pochek pri ozhirenii (Obzor literatury). Nefrologiya i dializ 2006; 8:2: 102-11.
54. Suzuki M, Kimura Y, Tsushima M, Harano Y. Association of insulin resistance with salt sensitivity and nocturnal fall of blood pressure. Hypertension 2000; 35: 864-8.
55. Ferrannini E, Barrett E, Bevilacqua S, et al. Sodium elevates the plasma glucoseresponse to glucose ingestion in man. J Clin Endocrinol Metab 1982; 54: 455-8.
56. Len da DM, Boegehold MA. Effect of a high-salt diet on oxidant enzyme activity in skeletal musclemicrocirculation. Am J Physiol 2002; 282: 395-402.
57. Meng S, Roberts J II, Cason GW, et al. Superoxide dismutase and oxidativestress in Dahl salt-sensitive and -resistant rats. Am J Physiol 2002; 283: 732-8.
58. Rugale C, Delbose S, Cristol JP, et al. Sodium restriction prevents cardiac hypertrophyand oxidative stress in angiotensin II hypertension. Am J Physiol 2003; 284: 1744-50.
59. Ishimitsu T, Tobian L, Sugimoto K, Everson T. High potassium diets reduce vascular and plasma lipid peroxidases in stroke-prone spontaneously hypertensive rats. Clin Exp Hypertens 1996; 18: 659-73.
60. Tobian L, Lange J, Ulm K, et al. Potassium reduces cerebral hemorrhage and death rate in hypertensive rats, even when blood pressure is not lowered. Hypertension 1985;7(Suppl I): 110-4.
61. Brenner BM, Mackenzie HS. Nephron mass as a risk factor for progression of renal disease. Kidney Int Suppl 1997; 63: 124-7.
62. Brenner BM, Meyer TW, Hostetter TH. Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesisof progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease.N Engl J Med 1982; 307: 652-9.
63. Hostetter TH, Olson JL, Rennke HG, et al. Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. Am J Physiol 1981; 241: 85-93.
64. Dworkin LD, Feiner HD. Glomerular injury in uninephrectomized spontaneously hypertensiverats. A consequence of glomerular capillary hypertension. J Clin Invest 1986; 77: 797-809.
65. Johnson RJ, Alpers CE, Yoshimura A, et al. Renal injury from angiotensin II-mediated hypertension. Hypertension 1992; 19: 464-74.
66. Bohle A, Kressel G, Muller CA, et al. The pathogenesis of chronic renal failure. Pathol ResPract 1989; 185: 421-40.
67. Bohle A, Mackensen-Haen S, von Gise H, et al. The consequences of tubulo-interstitialchanges for renal function in glomerulopathies. A morphometric and cytological analysis. Pathol Res Pract 1990; 186: 135-44.
68. Risdon RA, Sloper JAC, de Wardener HE. The relationship between renal function andhistological changes found in renal biopsy specimens from patients with persistent glomerulonephritis. Lancet 1968; 2: 363-6.
69. Struiker GE, Schainuck LI, Cutler RE, et al. Structural-functional correlations in renal disease.I. A method for assaying and classifying histopathologic changes in renal disease. Hum Pathol 1970; 1: 631-41.
70. Hayashi K, Epstein M, Loutzzenhiswer R, et al. Impaired myogenic responsiveness of theafferent arteriole in streptozocin-induced diabetic rats: role of eicosanoid derangements. J Am Soc Nephrol 1992; 2: 1578-86.
71. Pelayo JC, Westcott JY. Impaired autoregulation of glomerular capillary hydrostatic pressurein the rat remnant nephron. J Clin Invest 1991; 88: 101-5.
72. Barretti P, Soares V. Importance of early and continuous use of protein restriction on the progression of adriamycin nephropathy. Ren Fail 1999; 21: 603-13.
73. Bertani T, Zoja C, Abbate M, et al. Age-related nephropathy and proteinuria in rats with intact kidneys exposed to diets with different protein content. Lab Invest 1989; 60: 196-204.
74. Brenner BM. Nephron adaptation to renal injury or ablation. Am J Physiol 1985; 249: 324-37.
75. Neugarten J, Feiner HD, Schacht RG, Baldwin DS. Amelioration of experimental glomerulonephritisby dietary protein restriction. Kidney Int 1983; 24: 595-601.
76. Zatz R, Meyer TW, Rennke HG, et al. Predominance of hemodynamic rather than metabolicfactors in the pathogenesis of diabetic glomerulopathy. Proc Natl Acad Sci USA 1985; 82: 5963-7.
77. Stamler J, Elliott MB, Kesteloot H, et al. Inverse relation of dietary protein markers with blood pressure: findings for 10020 men and women in the Intersalt Study. Circulation 1996; 94: 1629-34.
78. Mitch WE. Beneficial responses to modified diets in treating patients with chronic kidney disease. Kidney Int 2005; 67(Suppl 93): 133-5.
79. Meyrier A, Simon P. Nephroangiosclerosis and hypertension: things are not as simple as you might think. Nephrol Dial Transplant 1996; 11: 2116-20.
80. Bohle A, Wehrmann M, Greschniok A, Junghans R. Renal morphology inessential hypertension: analysis of 1177 unselected cases. Kidney Int 1998; Suppl 67: 205-6.
81. Olson JL. Hypertension: essential and secondary forms. In: Heptinstall’sPathology of the Kidney, 5th ed. Jennette JC, Olson JL, Schwartz M, Silva FG,eds. Philadelphia: Lippincott-Raven 1998; 943-1001.
82. Kincaid-Smith P, Whitworth JA. Hypertension and the kidney. In: The Kidney:A Clinicopathologic Study. Eds: Kincaid-Smith P, Whitworth JA. Melbourne: Blackwell, 1987; 131.
83. Shulutko B.I., Perov YuL. Arterial'naya gipertenziya. SPb.: «Liga» 1993; 304 s.
84. Miall WE, Oldham PD. Factors influencing arterial blood pressure in the general population. Clin Sci 1958; 17: 409-16.
85. Andreucci VE, Fuiano G, Russo D, et al. Vasomotor nephropathy in the eldery. Nephrol Dial Transplant 1998; Vol 13(Suppl.7): 17-24.
Review
For citations:
Volkov V.S., Tofilo A.P. Aetiological and pathogenetic factors of primary arterial hypertension. Cardiovascular Therapy and Prevention. 2010;9(7):105-111. (In Russ.)
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ISSN 2619-0125 (Online)
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