The Etiology of Hypertension in the Metabolic Syndrome Part Three: The Regulation and Dysregulation of Blood Pressure

Authors: Sharma, Vijay; McNeill, John H.

Source: Current Vascular Pharmacology, Volume 4, Number 4, October 2006 , pp. 321-348(28)

Publisher: Bentham Science Publishers

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Abstract:

To understand blood pressure is regulated, and how this regulation is disturbed in hypertension, we need to understand how blood volume is regulated and how the distribution of that volume across the vascular tree is regulated. Here we review the literature on blood volume regulation and how it is disturbed in the pre-diabetic and diabetic state. We also provide a comprehensive overview of vascular dysfunction, discussing the key mechanisms, mediators and pathways which are involved. In particular, we focus on the key concept of endothelial dysfunction and how this has shaped our understanding of hypertension.

Keywords: Metabolic syndrome; diabetes; hypertension; obesity; insulin resistance; volume homeostasis; endothelial dysfunction; kidney; sympathetic nervous system; renin-angiotensin system

Document Type: Research article

DOI: http://dx.doi.org/10.2174/157016106778521643

Affiliations: 1: Division of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, Vancouver, V6T 1Z3, Canada.

Publication date: 2006-10-01

More about this publication?

Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials.

Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units). Current Vascular Pharmacology will publish reviews to update all those concerned with the treatment of vascular disease. For example, reviews commenting on recently published trials or new drugs will be included. In addition to clinically relevant topics we will consider 'research-based' reviews dealing with future developments and potential drug targets. Therefore, another function of Current Vascular Pharmacology is to bridge the gap between clinical practice and ongoing research.

Debates will also be encouraged in the correspondence section of this journal.

The Etiology of Hypertension in the Metabolic Syndrome Part Three: The Regulation and Dysregulation of Blood Pressure

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