The lord of the ring: mandatory role of the kidney in drug therapy of hypertension.

摘要: Strong evidence supports the idea that total peripheral resistance (TPR) is increased in all forms of human and experimental hypertension. Although etiological participation TPR origin long-term maintenance hypertension has been extensively debated, it now seems clear renal, nonadaptive, infinite gain-working, pressure-sensitive natriuresis diuresis main mechanism blood pressure control long term. The tissue, cellular, biochemical, genetic sensors executors this process have not fully identified yet, but role renal medulla gained growing attention as physiopathological scenario which key regulatory elements reside. Specifically, functionality renomedullary vasculature to be highly responsible for control. becomes a new more specific target therapeutic intervention Recent data on effect baroreceptor-controlled sympathetic activity regulation are integrated. effects antihypertensive drugs discussed, perspectives outlined. Comparison program before after development spontaneously hypertensive experimentally induced animal models might provide identifying genes become activated or suppressed high pressure. These genes, their encoded proteins, other related signalling pathways serve targets pharmacological treatment abnormally elevated Besides, proteins specifically located luminal side vascular endothelium may potential site-directed drug gene therapy.