Pathogenesis of essential hypertension--present views

The paper reviews the main lines of research pertaining to modern understanding of pathogenesis of essential hypertension. Attention is focused on the role of sympathetic activity, including the neuropeptide Y, as well as on those of atrial natriuretic peptide, endothelins and nitric oxide. The concept of endothelial dysfunction is discussed as a possible factor contributing to the development of hypertension, but also as its sequel. Finally, hyperinsulinemia and insulin resistance are viewed within a scope of interrelated factors of possible pathogenetic significance in essential hypertension. Genetic studies are singled out as the most promising line of further research.