Autocrine-paracrine factors and vascular remodeling in hypertension.

Despite decades of intense research, the etiology of essential hypertension remains one of the major enigmas of clinical medicine. On the basis of recent advances in the vascular biology of hypertension two important paradigms have emerged that offer promise in solving this enigma: 1) the concept of vascular remodeling, and 2) the concept of vascular autocrine-paracrine factors as determinants of vascular resistance. These concepts are interrelated because vascular autocrine-paracrine factors appear to mediate the process of vascular remodeling. This review focuses on these two emerging paradigms and their potential importance in elucidating the pathogenic mechanisms of hypertension.