Dal Palù C
1 Clinica Medica, Padova, Italy.
J Hum Hypertens. 1996 Sep;10 Suppl 3:S89-92.
A minimum level of blood pressure is necessary for atherosclerosis to develop, even in the presence of hypercholesterolemia. Experimentally and clinically we have both examples of atherosclerosis in which hypercholesterolemia is the dominant pathogenetic factor and others in which hypertension prevails (BBWT). The pathogenetic role of hypertension may be direct (wall stress) or mediated through humoral factors which characterize the different types of hypertension (renin, angiotensin, cathecholamines, endothelin, aldosterone). Probably, different forms of atherosclerosis will be identified in the future, with a different prognosis and therapeutical approach.
即使存在高胆固醇血症，动脉粥样硬化的发生也需要有最低水平的血压。在实验和临床中，我们既有以高胆固醇血症为主要致病因素的动脉粥样硬化实例，也有以高血压为主导的实例（双侧肾切除高血压）。高血压的致病作用可能是直接的（血管壁压力），也可能是通过表征不同类型高血压的体液因素介导的（肾素、血管紧张素、儿茶酚胺、内皮素、醛固酮）。未来可能会识别出不同形式的动脉粥样硬化，其预后和治疗方法也会有所不同。
