Lembo G, Vecchione C, Morisco C, Fratta L, Argenziano L, Sarno D, Trimarco B
IRCCS Sanatrix di Pozzilli, IS.
Ann Ital Med Int. 1995 Oct;10 Suppl:69S-72S.
Several epidemiologic studies have demonstrated that hypertensive patients have an increased risk for the development of atherosclerosis. Although the appearance of atherosclerosis only in those parts of vascular system subjected to high blood pressure suggests that the mechanical stress is the principal factor involved in the development of atherosclerosis, the mechanisms underlying the linkage between hypertension and atherosclerosis are not yet completely understood. In fact, the evidence that antihypertensive treatments are not able to abolish the increased incidence of ischemic accidents in hypertensive patients suggests that other cellular and molecular mechanisms are involved in the pathogenesis of atherosclerosis. The pathogenesis of hypertension is a multifactorial process that involves the interaction of genetic and environmental factors which determine the abnormalities of volume regulation, the enhanced vasoconstriction and the remodeling of the arterial wall which is characterized by hypertrophy and proliferation of vascular smooth muscle cells. On the other hand, the increased growth response of vascular smooth muscle cells represents one of the principal characteristics of atherosclerosis. Thus, increased vascular smooth muscle cell growth is a common feature in the pathogenesis of both atherosclerosis and hypertension.
多项流行病学研究表明，高血压患者发生动脉粥样硬化的风险增加。虽然动脉粥样硬化仅出现在承受高血压的血管系统部位，这表明机械应力是参与动脉粥样硬化发展的主要因素，但高血压与动脉粥样硬化之间联系的潜在机制尚未完全明了。事实上，抗高血压治疗无法消除高血压患者缺血性意外事件发生率增加的证据表明，其他细胞和分子机制也参与了动脉粥样硬化的发病过程。高血压的发病机制是一个多因素过程，涉及遗传和环境因素的相互作用，这些因素决定了容量调节异常、血管收缩增强以及以血管平滑肌细胞肥大和增殖为特征的动脉壁重塑。另一方面，血管平滑肌细胞生长反应增强是动脉粥样硬化的主要特征之一。因此，血管平滑肌细胞生长增加是动脉粥样硬化和高血压发病机制中的一个共同特征。
