What is the pathophysiology of primary hypertension?
The genesis of primary hypertension is not completely understood. Primary hypertension demonstrates a polygenic pattern of inheritance, and it is clear that multiple environmental and genetic factors coalesce. While BP is the product of systemic vascular resistance and cardiac output, the final common pathway is an elevation in systemic vascular resistance. Multiple lines of investigation have linked derangements in the kidney, vasculature, central and systemic nervous system, immune system, and cardiovascular system to the generation and maintenance of systemic hypertension. Heightened sympathetic tone, increases in total body sodium, and excess activation of the renin-angiotensin-aldosterone axis, among others, remain the commonly cited drivers of increased vascular tone. More recently, imbalances between endogenous vasoconstrictors, such as endothelin, and vasodilators such as nitric oxide have been implicated.
