title: The structural factor of hypertension: large and small artery alterations.
abstract: Pathophysiological studies have extensively investigated the structural factor in hypertension, including large and small artery remodeling and functional changes. Here, we review the recent literature on the alterations in small and large arteries in hypertension. We discuss the possible mechanisms underlying these abnormalities and we explain how they accompany and often precede hypertension. Finally, we propose an integrated pathophysiological approach to better understand how the cross-talk between large and small artery changes interacts in pressure wave transmission, exaggerates cardiac, brain and kidney damage, and lead to cardiovascular and renal complications. We focus on patients with essential hypertension because this is the most prevalent form of hypertension, and describe other forms of hypertension only for contrasting their characteristics with those of uncomplicated essential hypertension.
authors.affiliation: From the Department of Pharmacology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France (S.L., P.B.); Université Paris-Descartes, Paris, France (S.L., P.B.); and INSERM U 970, Paris, France (S.L., P.B.). stephane.laurent@egp.aphp.fr.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Laurent
authors.affiliation: From the Department of Pharmacology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France (S.L., P.B.); Université Paris-Descartes, Paris, France (S.L., P.B.); and INSERM U 970, Paris, France (S.L., P.B.).
authors.forename: Pierre
authors.initials: P
authors.lastname: Boutouyrie
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D017209:Apoptosis; D001158:Arteries / Q000473:pathology* / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology; D018450:Disease Progression; D005109:Extracellular Matrix / Q000502:physiology; D018056:Hemorheology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D009122:Muscle Hypertonia; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D011673:Pulsatile Flow; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D066253:Vascular Remodeling / Q000502:physiology; D059289:Vascular Stiffness / Q000502:physiology; D014661:Vasoconstriction / Q000502:physiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
keywords: arterial stiffness; arterioles; brain; heart; hypertension; kidney