Pathogenesis of essential hypertension: Development of a 4-dimensional model

Essential hypertension (EH) is regarded as a multifactorial and poly- genic disease, and its underlying mecha- nism is very complex. A new model of EH pathogenesis was developed in the pres- ent work. This model is suitable for the study, diagnosis, treatment, and preven- tion of EH. It incorporates not only genetic and environmental factors, but also com- pensatory and time factors as the third and fourth types of factors that contribute to the development of EH. Compensatory factors are defined here as specific blood pressure (BP) regulators, the ability of the body to regulate BP, and the process of BP regulation. Time factors include the age of the patient and the duration of EH in that patient. Over time, genetic, environmental, compensatory, and time factors are dy- namic. In this way, the development of EH is influenced by the interactions between these four factors. Herein, a 4-dimension- al (4-D) model of EH pathogenesis is de- scribed, including primary approaches and technical considerations. The 4-D model will be useful in understanding the pathogenesis, diagnosis, treatment, and prevention of EH.