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Hypertension and atherosclerosis.

A minimum level of blood pressure is necessary for atherosclerosis to develop, even in the presence of hypercholesterolemia. Experimentally and clinically we have both examples of atherosclerosis in which hypercholesterolemia is the dominant pathogenetic factor and others in which hypertension prevails (BBWT). The pathogenetic role of hypertension may be direct (wall stress) or mediated through humoral factors which characterize the different types of hypertension (renin, angiotensin, cathecholamines, endothelin, aldosterone). Probably, different forms of atherosclerosis will be identified in the future, with a different prognosis and therapeutical approach.