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May 16, 2026European Heart Journal32 citations

Vascular remodelling in hypertension

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MMMichael J. Mulvany

Key Result

Vascular remodelling, involving the rearrangement of material around a smaller lumen, is reviewed as an important factor in the pathogenesis of essential hypertension.

Key Points

  • To evaluate the evidence that structural vascular remodelling, rather than wall growth alone, drives the increased media-to-lumen ratio observed in the resistance vasculature during essential hypertension.
  • Narrative review synthesizing morphological and physiological evidence on resistance vessel architecture in essential hypertension.
  • Comparison of mechanisms underlying vascular wall growth versus structural rearrangement around a smaller vessel lumen.
  • Resistance vasculature in essential hypertension consistently displays an elevated ratio of media thickness to lumen diameter.
  • Evidence demonstrates that structural alterations can occur through the rearrangement of existing vascular wall tissue rather than net encroaching tissue growth.

Structured PICO

P
Population
Patients with essential hypertension

This review highlights vascular remodelling as a key mechanism in the structural alterations of resistance vasculature in essential hypertension.

Abstract

Essential hypertension is associated with alterations in the structure of the resistance vasculature, such that the ratio of the media thickness to the lumen diameter (media:lumen ratio) is increased. These abnormalities have previously been explained in terms of vascular growth (an encroachment of the wall into the lumen), but the abnormalities could also be due to a rearrangement of a normal amount of material around a smaller lumen, a process known as 'remodelling'. This paper reviews briefly some of the evidence for vascular remodelling as an important factor in the pathogenesis of essential hypertension.

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Cite This Study

Michael J. Mulvany (1993) conducted a review in Essential hypertension. Vascular remodelling, involving the rearrangement of material around a smaller lumen, is reviewed as an important factor in the pathogenesis of essential hypertension.

synapsesocial.com/papers/6a088af2119e94a920413bf7https://doi.org/10.1093/eurheartj/14.suppl_c.2
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