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Pathophysiology of Hypertension: The Mosaic Theory and Beyond

David G Harrison1, Thomas M Coffman2, Christopher S Wilcox3

  • 1Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (D.G.H.).

Circulation Research
|April 1, 2021
PubMed

Insights

Hypertension is a complex condition influenced by multiple interacting factors, as proposed by the Mosaic Theory. Recent advancements in understanding oxidative stress, inflammation, genetics, and the microbiome refine this theory, highlighting the interdependence of these elements.

Area of Science:

  • Cardiovascular Research
  • Hypertension Pathophysiology

Background:

  • The Mosaic Theory of Hypertension, proposed by Dr Irvine Page in the 1940s, posits that hypertension results from numerous interacting factors.
  • This theory has evolved over time, incorporating new scientific insights.

Purpose of the Study:

  • To review and discuss recent advancements that refine the Mosaic Theory of Hypertension.
  • To introduce a compendium of reviews on hypertension.

Main Methods:

  • Literature review of new concepts related to hypertension.
  • Discussion of factors including oxidative stress, inflammation, genetics, sodium homeostasis, and the microbiome.

Main Results:

  • New concepts such as oxidative stress, inflammation, genetics, sodium homeostasis, and the microbiome allow for further refinements of the Mosaic Theory.
  • The interdependence of various factors in hypertension is a constant feature, varying between models and individuals.

Conclusions:

  • The Mosaic Theory provides a framework for understanding hypertension as a multifactorial disease.
  • Continued research into the complex interactions of these factors is crucial for advancing hypertension management.

Keywords:
blood pressurehistoryhypertensioninflammationreactive oxygen species

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