Article Sections

Introduction

Essential (primary) hypertension is a chronic condition characterized by consistently elevated blood pressure without a known secondary cause.  It affects a significant portion of the adult population and is a major risk factor for cardiovascular disease, including myocardial infarction, stroke, and heart failure.  The etiology of essential hypertension is multifactorial and complex.

Pathophysiology

Key mechanisms likely include the following:

  • Genetic predisposition:  Several genetic loci have been associated with blood pressure regulation, influencing renal sodium handling, vascular tone, and sympathetic nervous system activity.
  • Renin-angiotensin-aldosterone system (RAAS):  Dysregulation of the RAAS leads to increased sodium and water retention, vasoconstriction, and aldosterone-mediated potassium excretion, all of which contribute to elevated blood pressure ( Figure 1).  Many antihypertensive agents act on this system ( Figure 2).
  • Endothelial dysfunction:

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Figures

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Tables

Table 1