Molecular and cellular mechanisms regulating vascular function and structure - Implications in the pathogenesis of hypertension

Human essential hypertension is a complex, multifactorial, quantitative tra it under polygenic control. The fundamental hemodynamic abnormality in hype rtension is increased peripheral resistance due primarily to changes in vas cular structure and function. These changes include arterial wall thickenin g and abnormal vascular tone, and are due to alterations in the biology of the cellular and noncellular components of the arterial wall. Multiple inte racting humoral and mechanical factors as well as oxidative stress stimulat e complex signalling pathways, which modulate vascular smooth muscle cell c ontraction and growth. Under nor mal physiological conditions, these finely regulated processes maintain vessel wall integrity and prevent pathologica l increases in blood pressure. However, under abnormal conditions, increase d humoral and mechanical signalling results in vascular wall thickening and increased vascular tone, which play an important role in the pathogenesis and maintenance of hypertension. The present: review discusses recent devel opments in the understanding of cellular and molecular mechanisms underlyin g vascular regulation in hypertension.