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Phylogenetic model for essential hypertension remains theoretical; leaves open any role in guiding clinical practice or targeted research.
Separate regulation of 2 arterial beds – phylogenetically early muscle arterioles (millions of local peristaltic pumps) and phylogenetically late proximal region, heart and elastic arteries – is the basis for the phenomenon that their non-coordination formed at different stages of phylogenesis manifests itself in functional disorders in paracrine cell communities. There is a small number of means to produce any effect on the paracrine cell community function at the level of the organism. Metabolic disorders in these communities can be normalized via the biological reaction of arterial pressure (AP). Pathogenesis of essential arterial hypertension is based on in vivo disorders of the biological functions of homeostasis, exotrophy, endoecology and adaptation. In essential hypertension, primary disorders form at the paracrine cell community level in the distal area of arterial bed, but not in the target organs. Only later, after compensatory activation of the biological reaction of AP and formation of discrepancy between regulations at the organism and paracrine cells communities, the process secondarily involves the target organs: kidneys, lungs and brains which have autonomous hemodynamics systems. The heart is the fourth target organ in essential hypertension. The pathogenesis of essential hypertension is based on phylogenetic discrepancy between metabolism regulation at the levels of the entire body and paracrine cell communities.
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В. Н. Титов (2013) studied this question.
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