Research Topic

Vascular Function in Arterial Hypertension: Current Knowledge and Future Challenges

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Arterial hypertension is a very common disease and is of great importance as a risk factor for cardiovascular disease. In patients with arterial hypertension, functional and structural vascular abnormalities may be found in the micro- and macrocirculation. Vascular dysfunction may be considered as a possible ...

Arterial hypertension is a very common disease and is of great importance as a risk factor for cardiovascular disease. In patients with arterial hypertension, functional and structural vascular abnormalities may be found in the micro- and macrocirculation. Vascular dysfunction may be considered as a possible pathogenical mechanism leading to hypertension and, at the same time, the vessels are one of the organs which may be damaged by persistent high blood pressure. Vascular endothelium plays a fundamental role in modulating vascular tone and structure, defending vessel wall from thrombosis and plaque formation.

The physiological production of the relaxing factors, including nitric oxide, prostacyclin and hyperpolarizing relaxing factors, protect the vessel wall by antagonizing the first pathogenetic steps of atherosclerosis and thrombosis. On the other side, endothelial cells may turn bad and produce endothelium-derived contracting factors. The principal component of these contracting factors is endothelin-1, which promotes the growth of the smooth muscle cells and has a vasoconstrictive and blood pressure raising effect. Defective nitric oxide production is already detectable in normotensive offspring of hypertensive patients and young essential hypertensives. A dysfunctional endothelium due to reduced nitric oxide availability associated with an increased production of oxidative stress and vasoconstricting factors is considered as an early indicator of atherothrombotic damage and of cardiovascular events also in patients with arterial hypertension. Moreover, other component of the vessel wall such as smooth muscle cell or component of the matrix are involved in the vascular dysfunction found in hypertension leading to arterial stiffness and atherothrombosis.

The aim of this Research Topic is to (1) review actual knowledge about vascular dysfunction in patients with essential and secondary hypertension, (2) evaluate vascular dysfunction in different vascular beds (eg micro vs macro circulation) and (3) assess the effects of life style changes, environmental factors or pharmacological interventions which may have an influence on vascular function in patients with arterial hypertension.

Potential themes will include:
- Vascular function and structural changes in experimental model of arterial hypertension and underlying mechanisms
- Vascular function and structural changes in human arterial hypertension and underlying mechanisms
- How to improve vascular function in patients with arterial hypertension
- Which life style factors/drugs have a negative effect on vascular function in patients with arterial hypertension, and which should be considered as protective


Keywords: Microcirculation, Macrocirculation, Lifestyle Factors, Environment, Pharmacology


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