Role of Endothelium in Hypertension

The endothelial lining of blood vessels is the one-cell-thick innermost layer and comprises endothelial cells. The endothelium plays an important role in the dynamic regulation of blood pressure (BP) (Fig. 9-1). Through hormones, cytokines, and other vasoactive factors, the endothelium communicates to and regulates the function of vascular smooth muscle tone. This is critical to the dynamic equilibrium of basal BP, and our understanding of how the body rapidly adjusts to changes in position or blood volume. Abnormalities of the endothelium are reflected in altered basal control of BP, and clearly contribute to the development of hypertension. In this chapter, I explore the important endothelial participants in BP control and suggest ways to modify these factors to yield normotension.