Recent Advances in the Pathophysiology of Hypertension

High blood pressure (hypertension) is a complex, multifactorial, and multisystem disorder and a leading cause of morbidity and premature death worldwide. It is the major modifiable risk factor for heart disease, stroke, and kidney disease. The underlying cause of hypertension is identified in ∼5% of patients (secondary hypertension), whereas in 95% of patients no specific etiology is found (primary hypertension). Multiple factors including genetics, environmental elements, hemodynamics, and interacting physiological systems contribute to the pathophysiology of hypertension. At the molecular level, growing evidence indicates an important role for oxidative stress, mitochondrial dysfunction, inflammation, epigenetics, and noncoding RNAs. In addition, new components of the renin-angiotensin system, including alamandine, have been discovered as potential players in the development of hypertension. Here we highlight some novel concepts on molecular mechanisms and pathophysiological processes underlying hypertension.