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Arteriosclerosis with superimposed atherosclerosis is the cause not the consequence of essential hypertension

Peter Gates1

  • 1Deakin University, Waurn Ponds Vic 3220, Australia.

Medical Hypotheses
|December 1, 2020
PubMed

Insights

Arterial stiffness, a consequence of arteriosclerosis, is the primary cause of essential hypertension. This arterial stiffening begins in utero and progresses with age, explaining the condition's increasing incidence.

Area of Science:

  • Cardiovascular Physiology
  • Hypertension Pathophysiology

Background:

  • The arterial system's pressure is determined by cardiac output, outflow resistance, blood volume, and arterial wall stiffness.
  • Essential hypertension is a complex condition with multifactorial causes that are not fully understood.

Purpose of the Study:

  • To identify the principal cause of essential hypertension.
  • To evaluate the role of arterial wall stiffness in the development of essential hypertension.

Main Methods:

  • Review of existing literature on arterial hemodynamics and hypertension.
  • Analysis of the relationship between arterial stiffness, arteriosclerosis, and essential hypertension.
  • Evaluation of etiological factors against Koch's postulates.

Main Results:

  • Increased resistance to outflow and increased cardiac output are not primary causes of essential hypertension.
  • Increased blood volume contributes to hypertension in specific conditions like obesity and renal failure.
  • Increasing arterial wall stiffness, due to arteriosclerosis, is the principal cause of essential hypertension.
  • Arterial stiffening precedes essential hypertension by decades and is present in all affected individuals.

Conclusions:

  • Arterial wall stiffening, a result of progressive arteriosclerosis, is the primary etiological factor in essential hypertension.
  • The age-related increase in essential hypertension incidence is explained by the progressive nature of arterial stiffening.
  • Arterial stiffness fulfills Koch's first postulate as a necessary condition for essential hypertension.

Keywords:
ArteriosclerosisAtherosclerosisEssential hypertension

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