Multiple roles for surface-active phospholipid in hypertension

The elusiveness of the agent responsible for primary hypertension and the diversity of its impact upon the body, as reflected by the widely differing and almost independent avenues of research in this field, indicate that the answer could lie with a particularly common substance in the body acting at various levels of fundamental physiological function. This hypothesis pursues some basic physics of phospholipid whereby a change in quantity or quality can affect the capability to generate extreme surface activity manifest as the numerous properties which this agent can impart to blood and to adjacent surfaces by adsorption. Nine possible roles are traced by which surface-active phospholipid could impinge upon neurogenic control of blood pressure, the effects of circulating relaxing factors, blood rheology, atherosclerosis, and the major renal aspects of control by diuresis and association with the antihypertensive neutral renomedullary lipid. This multi-faceted approach offers mechanisms by which diet can affect blood pressure in addition to the traditional emphasis upon the deposition of atheroma.