What is the clinical evidence from this study?

Study design: Review. Population: Primary hypertension.

What does this research mean for the field?

Primary hypertension is a systemic disorder driven by interrelated dysregulation of the renin-angiotensin-aldosterone system, central nervous system dysfunction, and inflammatory and oxidative stress pathways. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To synthesize current molecular and cellular evidence conceptualizing primary hypertension as a systemic disorder driven by interconnected neurohumoral, metabolic, and immune pathways.

October 1, 2026Journal of Cellular PhysiologyOpen Access

Molecular and Cellular Underpinnings of Primary Hypertension: An Integrative Mechanistic Framework

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Key result

Primary hypertension stems from interrelated dysregulation of the RAAS, central nervous system, and inflammatory pathways.

Why the study?

The complex and multifactorial pathogenesis of primary hypertension remains incompletely elucidated despite extensive research.

Key Points

To synthesize current molecular and cellular evidence conceptualizing primary hypertension as a systemic disorder driven by interconnected neurohumoral, metabolic, and immune pathways.
Narrative review synthesizing mechanistic research on the pathophysiological drivers of primary hypertension.
Evaluation of interactions between core regulatory axes, environmental modifiers, and multi-organ dysfunction across renal, vascular, immune, and central nervous systems.
Primary hypertension is driven by a self-reinforcing triad comprising renin-angiotensin-aldosterone system dysregulation, central nervous system hyperactivity, and chronic inflammatory and oxidative stress pathways.
Core pathophysiological axes converge with lifestyle and metabolic factors, including gut microbiota dysbiosis, circadian rhythm misalignment, salt sensitivity, and insulin resistance, to perpetuate vascular remodeling and elevated peripheral resistance.
Therapies modulating upstream mechanisms—such as selective immune pathway targeting, gut microbiome interventions, and chronotherapy—show mechanistic potential over single-target symptomatic blood pressure reduction.

PICO

Population

Primary hypertension

This review provides an integrated framework underscoring the interplay between neural, renal, and immune pathways in hypertension, highlighting the need for holistic, upstream-targeted therapeutic strategies.

Discussion

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Implication

May support multi-pathway interventions in primary hypertension; extends integrative models but leaves open optimal targets for trials.

Cite This Study

Nasrallah et al. (2026) conducted a review in Primary hypertension. Primary hypertension is driven by the interrelated dysregulation of the renin-angiotensin-aldosterone system, central nervous system, and inflammatory pathways.

synapsesocial.com/papers/6abda8ff4d657f10339f955c https://doi.org/10.1002/jcp.70233

Topics

Hypertension management

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Molecular and Cellular Underpinnings of Primary Hypertension: An Integrative Mechanistic Framework

Key Points

PICO

Discussion

Implication

Cite This Study

Topics

Molecular and Cellular Underpinnings of Primary Hypertension: An Integrative Mechanistic Framework

Key Points

PICO

Discussion

Implication

Cite This Study

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