The Endothelium and Arterial Hypertension
Keywords:
Arterial hypertension, nitric oxide, endotheliumAbstract
Essential hypertension is associated with endothelial dysfunction. This is caused by free
oxygen radicals that destroy nitric oxide, impairing its protective effects on the vascular wall.
The endothelium has an autocrine/paracrine function, regulating the secretion of substances
that control vascular tonus and structure. It produces relaxing factors, such as Nitric oxide
and prostacycline, as well as constricting ones such as endothelin.
By definition, endothelial dysfunction is a reversible functional alteration of the endothelial cell, resulting from deficient availability of nitric oxide.
In hypertensive patients, endothelial dysfunction, although not directly responsible for the elevation of blood pressure, is a promoter for the atherosclerotic lesion and the main complications of hypertensive disease and thus becomes
a goal for antihypertensive therapy.
So far, the evidence about the prognostic value of endothelial dysfunction in patients with cardiovascular risk factors, including
hypertension, is scarce. This makes it difficult to establish if pharmacological therapy of this
entity represents an adjuvant beneficial effect beyond that of blood pressure control, namely
on morbidity and mortality reduction in the hypertensive population.
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