Arterial hypertension and hypertensive disease (syndromic diagnosis and nosological syndrome)

Fundamental innovations in the study of the regulatory mechanisms of circulation in the past 20-30 years (evidence for the role of the endothelium in local hemodynamic control, the basic significance of the tissue (paracrine) link of the angiotensin mechanism of not only as a vasoconstrictor, but also a trigger of a slow pressor component that leads to resistance bed arterial remodeling) have required the concept of the pathogenesis of hypertensive disease (HD) (essential hypertension) to be reconsidered, confirmed its qualificational (nosological) isolation (by the criterion of the presence of an attributive functional and structural sign). The new refined and concrete information on the pathogenesis of HD and its associated cardiovascular disease has shown to give doctors reliable landmarks to optimize drug therapy: both symptomatic (to accelerate effective blood pressure control) and basic (to eliminate endothelial dysfunction and to restore remodeled arteries and microcirculation) therapies.

hypertensive disease, pathogenesis, treatment optimization