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In the last two decades, investigations at the cellular level have
progressively gained ground in the context of hypertension
research. This choice of approach is due to some extent to the
build up of know-how that molecular and cellular biology have been
producing at a continuous rate. As the contents list of this volume
shows, a large mass of work has been directed to gaining some
insight into pathogenetic mechanisms. The pathogenesis of primary
hypertension has been progressively categorized as a distinct
biological problem, not amenable to the theoretical models that
proved successful in understanding the nature of secondary forms of
hypertension. At the same time, great efforts have been made to
simplify this problem by sorting out, if possible, a few crucial
mechanisms from the network of contributory factors in the
regulation of blood pressure. The idea that what is to be sought is
a primary structural and/or functional fault in arterial muscle has
met with widespread acceptance. The strength of this argument lies
in the fact that peripheral vascular resistance is increased in all
forms of hypertension and, in turn, the diameter of resistance
vessels is the dominant factor in the computation of total per
ipheral resistance. On the basis of this, cardiovascular structural
adaptation was proposed as a positive feedback mechanism tending to
maintain hypertension, once begun, whatever the initiating factor
is.
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