title: The patho-physiology of chronic arterial hypertension: a hypothesis.
abstract: An important unresolved problem in hypertension is how an elevated blood pressure from any cause may eventually become self-sustaining and apparently independent of the initiating event. Folkow has suggested that this results from arteriolar narrowing due to a physiological response or " structural adaptation" to the higher pressure, but it is suggested here that the histological appearances within arterioles in chronic hypertension are much more in keeping with a pathological process, and not vastly different from those observed after intimal damage to larger arteries in experimental atherosclerosis. From this, it is proposed that the arteriolar narrowing is secondary to the endothelial damage which arises when a maintained cardiac output is forced through a constricted arteriolar bed, so increasing substantially the shearing stress on their walls.
mesh_terms: D001160:Arterioles / Q000473:pathology / Q000503:physiopathology; D001161:Arteriosclerosis / Q000150:complications; D002302:Cardiac Output; D002908:Chronic Disease; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology*; D014655:Vascular Resistance; D014661:Vasoconstriction