The numerous pathophysiological theories in the field of essential hypertension are often conflicting, and till now a comprehensive model is not available. The aetiology of human hypertension is probably multifactorial, the control mechanisms of hypertension are strictly interdependent, and the alteration of one induces readjustment of the others, so that it is very difficult to discriminate the "primum movens" from its consequences. In this review the recent acquisitions in the aetiology and the pathophysiology of arterial hypertension are analysed, with particular regard to the role of inheritance, of renal mechanisms of sodium retention, ions transport, humoral factors, central nervous system and of enhanced vascular reactivity. The activation of some of these pathophysiological factors induces the rise in peripheral vascular resistance, which is the final common pathway in the development of essential hypertension.
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