The vasoconstriction-volume spectrum in normotension and in the pathogenesis of hypertension

Abstract

A body of evidence has been reviewed indicating that all hypertensive phenomena ranging from mild disorders to fulminant malignant hypertension can be profitably analyzed by assessing the relative contribution of two final determinants of the arterial blood pressure--the vasoconstriction and volume components. Renin-sodium profiling and the separate application of specific pharmacologic probes provide the basic tools for identifying the relative contribution of the two components. For an equal degree of hypertension, volume forms appear to exhibit better organ flow than the more vasoconstricted forms. This bidimensional analysis has provided new understanding of the pathophysiological mechanisms of the spectrum of human hypertensive diseases of practical value for the evaluation, diagnosis, and treatment of individual patients. Beyond this, the analytical scaffold identifies some key questions for future research.