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[Arterial hypertension and atherosclerosis: their epidemiology and physiopathology]
G Lembo1, C Vecchione, C Morisco
1IRCCS Sanatrix di Pozzilli, IS.
Insights
Hypertension and atherosclerosis share common pathways, particularly the abnormal growth of vascular smooth muscle cells. Understanding these shared mechanisms is crucial for developing effective treatments for both conditions.
Area of Science:
- Cardiovascular Science
- Pathophysiology
- Epidemiology
Context:
- Hypertension is linked to increased atherosclerosis risk.
- Mechanical stress from high blood pressure contributes to atherosclerosis.
- Antihypertensive treatments do not fully prevent ischemic events, suggesting other mechanisms are involved.
Purpose:
- To explore the shared cellular and molecular mechanisms linking hypertension and atherosclerosis.
- To investigate the role of vascular smooth muscle cell growth in both diseases.
Summary:
- Hypertension and atherosclerosis share common pathogenic features, notably the abnormal growth and proliferation of vascular smooth muscle cells (VSMCs).
- While mechanical stress is a factor, other cellular mechanisms are implicated in hypertension-related atherosclerosis.
- Hypertension involves genetic and environmental factors affecting vascular remodeling, including VSMC hypertrophy and proliferation.
- Atherosclerosis is characterized by an increased growth response of VSMCs.
- Therefore, enhanced VSMC growth is a key commonality in the pathogenesis of both hypertension and atherosclerosis.
Impact:
- Highlights shared pathways between hypertension and atherosclerosis.
- Suggests potential therapeutic targets focusing on vascular smooth muscle cell regulation.
- Informs strategies for preventing ischemic events in hypertensive patients.
Abstract:
Several epidemiologic studies have demonstrated that hypertensive patients have an increased risk for the development of atherosclerosis. Although the appearance of atherosclerosis only in those parts of vascular system subjected to high blood pressure suggests that the mechanical stress is the principal factor involved in the development of atherosclerosis, the mechanisms underlying the linkage between hypertension and atherosclerosis are not yet completely understood. In fact, the evidence that antihypertensive treatments are not able to abolish the increased incidence of ischemic accidents in hypertensive patients suggests that other cellular and molecular mechanisms are involved in the pathogenesis of atherosclerosis. The pathogenesis of hypertension is a multifactorial process that involves the interaction of genetic and environmental factors which determine the abnormalities of volume regulation, the enhanced vasoconstriction and the remodeling of the arterial wall which is characterized by hypertrophy and proliferation of vascular smooth muscle cells. On the other hand, the increased growth response of vascular smooth muscle cells represents one of the principal characteristics of atherosclerosis. Thus, increased vascular smooth muscle cell growth is a common feature in the pathogenesis of both atherosclerosis and hypertension.