Essential hypertension (EH) is the most common type of high blood pressure and is responsible for much death and serious illness, which has been the reason for the huge research effort to determine its causes. However, countless scientific articles still keep proclaiming that "the causes of essential hypertension remain unknown." In view of the number of publications that descend on the hypertension specialist like a waterfall, such proclamations seem to overlook the considerable amount of knowledge that we already have about the etiology of EH. The problem may be a lack of synthesis rather than a lack of information. This book provides a unique synthesis of the pathophysiology of essential hypertension (EH), which is limited through the brain and is critically dependent on both genetic and environmental factors such as stress, high salt intake and obesity. Korner analyses the mechanisms by which the various factors raise blood pressure and the pathophysiology of EH compared with that in renal hypertension and in some of the rat models of genetic hypertension. In some individuals stress-induced vasoconstriction enhances the brain's responsiveness to salt, giving rise to stress-and-salt-related EH. In others, stress-induced EH promotes eating, causing hypertensive obesity. Improving lifestyle through regular exercise and reduction of salt and calorie intake directly antagonises the environmental causes of EH, and has implications for prevenion and treatment.
Readership: Cardiologists and medical students.
Paul I. Korner, Professor of Physiology, University of New South Wales, Australia
"...an invaluable resource to physicians and researchers in hypertension...essential." - British Journal of Hospital Medicine
"Dr Korner successfully integrates vast amounts of information learned from research on the pathogenesis of essential hypertension into one comprehensive reference. Initial alterations of neural pressure regulatory systems are expertly detailed providing targeted areas for expanded research." - Doody's Notes
I. Introduction 1: A Short History and some Clinical Aspects II. Biological Control 2: The Nature of the Cardiovascular Control System 3: Blood Pressure Genetics III. Input-Output Analysis: Pointers to Neural Involvement 4: Human Arterial Pressure 5: Output Patterns in Non-Obese Hypertensives IV. Intrinsic Cardiovascular Properties in Hypertension 6: The Peripheral Vascular Integrator 7: Cardiac Performance V. Interactive Aspects of Neural Circulatory Control 8: CNS Cardiovascular Pathways: Role of Fast and Slow Transmitters 9: Whole-Organism Baroreflexes 10: Exercise Training and Its Long-Term Effects on Blood Pressure: Linkage to Somatic Movement VI. The Brain as the Source of Lifestyle-Related Hypertension 11: Psychosocial Stress and Hypertension 12: Salt, Other Dietary Factors, and Blood Pressure 13: Normotensive and Hypertensive Obesity 14: Obstructive Sleep Apnoea VII. Causes and Mechanisms of Renal and SHR Hypertension 15: More About the Kidney in Hypertension 16: SHR Hypertension and Its Causes VIII. Synthesis 17: Two Syndromes of Essential Hypertension
