Hypertension - en circulus vitiosus: patofysiologiske synspunkter

SummaryThe changes in function and structure of the high pressure compartments in experimental hypertension in animals are briefly reviewed. Several studies have demonstrated a gradual restructuring of the high pressure compartments, characterized by media hypertrophy in the arterioles and muscular hypertrophy in the left ventricular wall. Functional studies in spontaneously hypertensive rats have demonstrated a gradual change in the haemodynamics from a hyperkinetic circulation in the early phase to a hypokinetic circulation when the hypertension has been established and lasted for several months.Based on personal data the central haemodynamics in man with essential hypertension is discussed. A recent 10-year haemodynamic follow-up study in untreated essential hypertension is presented. These results are consistent with the concept of a similar restructuring of the high pressure compartments also in man with essential hypertension. Over the 10-year period, there was a decrease in cardiac index at rest an...