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This review discusses the role of vascular smooth muscle function and total peripheral resistance in the pathophysiology of hypertension.
Hypertension is defined by an increase in systemic blood pressure above limits considered normal, currently set at 140 mmHg for systolic and 90 mmHg for diastolic pressure. Assuming central venous pressure to be near zero, mean arterial pressure is determined by the product of total peripheral resistance and cardiac output. In most cases of essential hypertension, as well as in animal models of hypertension, cardiac output and its main determinants, stroke volume and heart rate, are normal, whereas total peripheral resistance is increased. Total peripheral resistance is influenced by a number of factors described by the Poiseuille’s law, the most significant of which by far is the diameter of blood vessels of the arterial tree. Since blood vessel diameter is a reflection of both vascular structure and active regulation of vascular tone through mechanisms of vasoconstriction and vasodilatation, it is generally considered that alterations in total peripheral resistance are directly determined by al...
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Szasz et al. (2016) studied this question.
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