WHILE WE HAVE BEEN "NEPHRO-CENTRIC" IN THE ROLE OF THE KIDNEY IN HYPERTENSION, WHAT OTHER ORGANS HAVE EMERGED AS POTENTIAL CONTRIBUTORS IN DEVELOPMENT OF HYPERTENSION
Novel concepts in
hypertension- beyond the kidney
Hypertension is one of the most common medical disorders. The pathogenesis of this complex disease
process is multifactorial and defining precisely which organ systems are
deranged continues to widen. For many
renal physiologists, Dr Arthur Guyton is seen as the patriarch of the
kidney-centric view of hypertension.
Guyton articulated his power studies where he argued that the kidney
plays a central role in the determination of long-term blood pressure. Guyton suggested that the control of blood
pressure and sodium balance are tightly linked.
His central tenet referred to as the pressure-natriuresis curve was
elegantly described in this paper published in Science in 1991. However, over the last several decades we have witnessed how complex blood
pressure regulation really is. It is not
surprising that multiple redundant systems are needed to control something as
fundamental to human life as blood pressure. In the next 3 posts, I shall discuss recent advances in
the understanding of hypertension from a basic science research perspective
involving the skin, central nervous system, and the immune system.
Stay tuned for role of skin, CNS and immune system in HTN in coming days.
Matthew Sparks, MD
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