Mar 6, 2009

Strain vessel hypothesis: a viewpoint for linkage of albuminuria and cerebro-cardiovascular risk

Hypertension Research : Official Journal of the Japanese Society of Hypertension
Sadayoshi ItoTakefumi Mori

Abstract

Albuminuria is closely associated with stroke and cardiovascular diseases (CVDs) as well as the salt sensitivity of blood pressure (BP). Although albuminuria may reflect generalized endothelial dysfunction, there may be more specific hemodynamic mechanisms underlying these associations. Cerebral hemorrhage and infarction occur most frequently in the area of small perforating arteries that are exposed to high pressure and that have to maintain strong vascular tone in order to provide large pressure gradients from the parent vessels to the capillaries. Analogous to the perforating arteries are the glomerular afferent arterioles of the juxtamedullary nephrons. Hypertensive vascular damage occurs first and more severely in the juxtamedullary glomeruli. Therefore, albuminuria may be an early sign of vascular damages imposed on 'strain vessels' such as perforating arteries and juxtamedullary afferent arterioles. Coronary circulation also occurs under unique hemodynamic conditions, in which the entire epicardial segments are exposed to very high pressure with little flow during systolic phases. From the evolutionary point of view, we speculate that such circulatory systems in the vital organs are mandatory for survival under the dange...Continue Reading

  • References73
  • Citations80

References

Mentioned in this Paper

Coronary Circulation
Ischemia
Cerebrovascular Occlusion
Circulatory System
Albuminuria
Structure of Afferent Arteriole
Strain Symptom
Blood Vessel
Brain
Renal Glomerular Disease

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