Oxidative stress, inflammation, immune system and hypertension

This chapter reviews the major structural changes in the heart and blood vessels in hypertension (HTN). In hypertensive patients, coronary vascular resistance and coronary perfusion pressure are increased. The chapter discusses how structural changes contribute to the target-organ damage in hypertensive disease. Cardiac organ damage in HTN is traditionally identified by left ventricular hypertrophy (LVH), which is an independent predictor of cardiovascular morbidity and mortality, representing an increased risk for ischaemic heart disease, stroke and eventually congestive heart failure. Elevated blood pressure leads to the development of structural changes in the heart. These changes consist mainly in the presence of LVH, of increased collagen content in the myocardium and in coronary vascular alterations. Concentric hypertrophy is the condition associated with the highest cardiovascular risk. The basic structure of the cardiovascular system is determined early in the development of an individual. Remodelling can also be part of a pathological series of events in the cardiovascular system and its end organs.