Essential Hypertension – Syndrome, or Compensatory Mechanism
Hulín I., Ďuriš I., Sapáková E., Paulis Ľ., Mravec B.
Ústav patologickej fyziológie LF UK, Bratislava, Slovenská republika Ústav experimentálnej endokrinológie SAV, Bratislava, Slovenská republika I. interná klinika FN a LF UK, Bratislava, Slovenská republika
Diagnosis of essential hypertension is created per exclusionem – with exclusion of all, so called
secondary hypertensions (nephrogenic, endocrine conditioned etc). Idea and the name-essential
hypertension are unclear. We have a lot of hypotheses about mechanisms of hypertension but no one is
explaining satisfactorily the „fixation“ of hypertension. From this point of view essential hypertension
looks more like a syndrome than disease sui generis. Authors analyzed all possible pathways of
hypertension origin as well as compensatory mechanisms in peripheral circulation in effort to reach
relevant tissue perfusion. If these mechanisms lead to salt and water retention the best mode of the
treatment would be to influence volume and blood vessels lumen. It is clear that optimization of blood
pressure is advantageous for prevention of vascular catastrophes (myocardial and cerebral infarction).
Nevertheless inadequate lowering of the peripheral tissue perfusion (kidney, CNS) can lead to
degenerative changes in tissues and to disturbances in centrally regulated processes of blood pressure.
beneficial hypertension, holistic view, capillary flow, kidney, sodium, stress, sympathetic