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International Journal of Hypertension
Volume 2013, Article ID 808353, 7 pages
http://dx.doi.org/10.1155/2013/808353
Review Article

Pathophysiology of Vascular Remodeling in Hypertension

1Department of Pathology, School of Medicine, National University of Cuyo, Avenida Libertador 80, Centro Universitario, 5500 Mendoza, Argentina
2Institute of Experimental Medicine and Biology of Cuyo (IMBECU), CONICET, Mendoza, Argentina
3Department of Physiology, School of Medicine, Universidad Complutense, Plaza de Ramón y Cajal s.n., 28040 Madrid, Spain

Received 16 January 2013; Revised 2 May 2013; Accepted 16 May 2013

Academic Editor: Kazuomi Kario

Copyright © 2013 Nicolás F. Renna et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Vascular remodeling refers to alterations in the structure of resistance vessels contributing to elevated systemic vascular resistance in hypertension. We start with some historical aspects, underscoring the importance of Glagov’s contribution. We then move to some basic concepts on the biomechanics of blood vessels and explain the definitions proposed by Mulvany for specific forms of remodeling, especially inward eutrophic and inward hypertrophic. The available evidence for the existence of remodeled resistance vessels in hypertension comes next, with relatively more weight given to human, in comparison with animal data. Mechanisms are discussed. The impact of antihypertensive drug treatment on remodeling is described, again with emphasis on human data. Some details are given on the three mechanisms to date which point to remodeling resistance arteries as an independent predictor of cardiovascular risk in hypertensive patients. We terminate by considering the potential role of remodeling in the pathogenesis of endorgan damage and in the perpetuation of hypertension.