Functional disturbance of the cell membrane in hypertension

Hypertension is associated with a variety of disturbances of cell membrane function. These associations have been attributed to changes in vascular smooth muscle sodium, calcium or PH, although direct evidence is conflicting in this context. While observations have been confounded by poor matching of the populations and technical shortcomings, it seems likely that genuine associations do exist. It is suggested that their significance can only be established by identifying the tissue abnormality responsible for elevated blood pressure. Evidence is cited that this abnormality is a structural increase in the resistance wall: lumen ratio, secondary to increased autonomic activity. A cell membrane disturbance could therefore give rise to hypertension, either through increased trophic responsiveness of the resistance vasculature or increased sympathetic drive to the resistance vessels. There is more direct evidence for the latter than the former.