[Impact of essential hypertension on the arteries]

Arterial remodeling has emerged as a key-concept in the pathophysiology of hypertension and its vascular damage. In any given arterial territory, hypertension-induced remodeling is characterized by an increased intima-media thickness, independently of the lumen and wall cross-sectional areas. Functional consequences of hypertension-induced arterial remodeling depend upon the caliber of the artery, and thus upon its function. In essential hypertension, the 2 major functional consequences of large artery remodeling are the long-term enhancement of atherosclerosis and the shorter-term preservation of elastic properties. The functional consequences of resistive arteries remodeling can be either deleterious (structural increase in peripheral vascular resistances, hyperreactivity to vasomotor stimuli, and decrease in perfusion reserve of target organs) or rather compensatory (changes in the autoregulation of regional perfusions).