Integrins, Vascular Remodeling, and Hypertension

A t the level of the resistance artery, hypertension also brings about a thickening of the vascular wall and inward encroachment on the lumen. This has been reported as being attributable to hypertrophy or hyperplasia of vascular smooth muscle cells (VSMCs), but studies have appeared suggesting that growth is not apparent in arteries at this level of the circulation. In addition, detailed structural and mechanical analyses have shown that eutrophic inward remodeling can narrow the vascular lumen without precipitating hypertrophy. 2,3 A small amount of hypertrophy may be observed, and in some pathological states, hypertrophy may supervene and is an adverse prognostic sign. For the remainder of this section, we consider the reasons why resistance arteries respond to hypertension in this manner.