GENETICS AND PATHOPHYSIOLOGY OF ESSENTIAL HYPERTENSION Edited by Madhu Khullar Genetics and Pathophysiology of Essential Hypertension Edited by Madhu Khullar Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. 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Publishing Process Manager Dejan Grgur Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Genetics and Pathophysiology of Essential Hypertension, Edited by Madhu Khullar p. cm. ISBN 978-953-51-0282-3 Contents Preface IX Part 1 Pathophysiology of Hypertension 1 Chapter 1 Harmful or Helpful Hypertension – Pathophysiological Basis 3 M. Kasko, M. Budaj and I. Hulin Chapter 2 Target Organ Damage in Essential Hypertension 17 Bogomir Žižek Chapter 3 Resistant Hypertension, Elevated Aldosterone/Renin Ratio and Reduced RGS2: A Pathogenetic Link Deserving Further Investigations? 43 Andrea Semplicini, Federica Stella and Giulio Ceolotto Chapter 4 Is Low Baroreflex Sensitivity only a Consequence of Essential Hypertension or also a Factor Conditioning Its Development? 67 Natasa Honzikova and Eva Zavodna Chapter 5 Does Music Therapy Reduce Blood Pressure in Patients with Essential Hypertension in Nigeria? 89 Michael Ezenwa Part 2 Genetics and Genomics of Hypertension 99 Chapter 6 Recent Trends in Hypertension Genetics Research 101 Padma Tirunilai and Padma Gunda Chapter 7 Candidate Genes in Hypertension 139 Hayet Soualmia Chapter 8 Mitochondrial Mutations in Essential Hypertension 169 Haiyan Zhu and Shiwen Wang VI Contents Chapter 9 Mitochondrial Mutations in Left Ventricular Hypertrophy 181 Haiyan Zhu and Shiwen Wang Chapter 10 Pharmacogenetics of Essential Hypertension 195 Madhu Khullar and Saurabh Sharma Chapter 11 Differential Gene Expression Profile in Essential Hypertension 211 Ping Yang Chapter 12 Potential Roles of TGF-1 and EMILIN1 in Essential Hypertension 223 Masanori Shimodaira and Tomohiro Nakayama Preface Hypertension or high blood pressure is one of the most common chronic diseases affecting more than 1 billion people worldwide, and by the year 2025, the global prevalence of hypertension is projected to increase to 29.2% of adult population (Kearney et al., 2005). High blood pressure where the medical cause of the disease is not known is defined as Essential hypertension and is the most common form of hypertension. Essential hypertension is a major risk factor for myocardial infarction, stroke, heart failure and renal failure. The cause of essential hypertension remains largely unknown and is an area of active research. It appears to have multifactorial and complex etiology where genetic and environmental factors play an important role. The current book addresses some of the research issues related to the pathophysiology, genetics and genomics of hypertension. This book is divided into two main sections: Pathophysiology, and Genetics and Genomics. In pathophysiology, topics such as pathophysiology of resistant hypertension, target organ damage in hypertension, Baroreflex sensitivity and an interesting hypothesis on music as a therapy for lowering blood pressure are described. Genetics and genomics section provides an overview of different aspects of genetics research in hypertension, including genetic susceptibility markers, mitochondrial mutations and pharmacogenetics of hypertension. A chapter on microarray technology details the technique and identifies expression of altered genes. Role of TGF-β and other inflammatory genes has been portrayed in another chapter. This book provides comprehensive information on some of the important topics and issues related to pathophysiology of essential hypertension and it is hoped that it will be useful to researchers and clinicians with an interest in Essential hypertension. Dr Madhu Khullar Department of Experimental Medicine & Biotechnology Post Graduate Institute of Medical Education and Research Chandigarh, India [...]... diagnosis of hypertensive target organ damage is of decisive importance The purpose of this review is to summarize current and emerging approaches to the pathophysiology, early detection and treatment of hypertensive disease 2 Etiopathogenesis of essential hypertension In spite of intensive investigation, etiology of essential hypertension (EH), which accounts for 90-95% of all cases of arterial hypertension. .. 16 Genetics and Pathophysiology of Essential Hypertension structural changes in the wall of the vessels: Thickening of the wall due to the hypertrophy of the media and hyperplasia of the collagen fibers That is the cause of the changes in the relation between the thickness of the vascular wall and its lumen Narrowing of the lumen alone can increase peripheral resistance In patients with developed hypertension. .. of this fact die due to hypertension Successfully treated patients 20 Genetics and Pathophysiology of Essential Hypertension compared with untreated live a little longer But they die on the same consequences as untreated patients with hypertension 10 References [1] Weder AB Evolution and hypertension Hypertension 2007;49:260-5 [2] Kaplan NM Clinical trials for hypertension: expectations fulfilled and. ..Part 1 Pathophysiology of Hypertension 1 Harmful or Helpful Hypertension – Pathophysiological Basis 1 2nd M Kasko1, M Budaj2 and I Hulin2 Department of Internal Medicine, University Hospital and Faculty of Medicine, Comenius University, Bratislava, 2Department of Clinical Pathophysiology, Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava,... known that electrophysiological measurements of intracellular and pericellular values of oxygen pressure range from 0 mmHg to 5 mmHg, and within the mixed venous blood it ranges between 30 mmHg and 40 mmHg The normal function of both isolated cells and cells within tissues requires pressure exceeding 2 mmHg [15] The 18 Genetics and Pathophysiology of Essential Hypertension most significant moment appears... resistance They participate in the changes of the potential volume of the capacity field 6 3 4 5 6 Genetics and Pathophysiology of Essential Hypertension pre-capillary sphincter is that part of the vessel that regulates blood flow into the capillaries and selectively distributes blood into those capillaries By opening and closing these segments we can determine the number of transition capillaries in a given... incidence of ischemic disease of the heart, heart failure, brain attack, and the incidence of lethal attacks It is necessary to understand the regulation of blood pressure and especially the molecular pathways of its regulation, to be able to treat it Despite our persistent struggle, we still do not know the details of many of its mechanisms We are successful in assessing the etiology of hypertension. .. only in 5%—15% of patients Secondary hypertension most often develops on the basis of primary hyperaldosteronism, Cushing's syndrome, feochromocytoma, atherosclerotic narrowing of renal artery (renovascular hypertension) or other disorders In 80%-95% of patients, the cause of hypertension is unknown So far, the efforts to find the factor that is responsible for the origin of this 'essential hypertension' ... the retention of fluids theoretically improve this state, yet eventually they bring about further fixation and progression of hypertension As a result of progressive damage to nephrons, a decrease in glomerular filtration takes place in advanced stages of the disease and further contributes to the retention of sodium and extracellular fluid Consequent comprehension of the pathomechanism of hypertension. .. also in human and not only in experimental animals The activity of Na+-K+ ATPase was proven to be low in erythrocytes, leukocytes, and even lymphocytes of patients with essential hypertension Low Na+-K+ ATPase activity is more prominent in patients with high or normo renin essential hypertension (according to the plasma renin activity we classify hypertension as: low-, normo-, and high renin hypertension) . GENETICS AND PATHOPHYSIOLOGY OF ESSENTIAL HYPERTENSION Edited by Madhu Khullar Genetics and Pathophysiology of Essential Hypertension Edited by. some of the research issues related to the pathophysiology, genetics and genomics of hypertension. This book is divided into two main sections: Pathophysiology, and Genetics and Genomics. In pathophysiology, . some of the important topics and issues related to pathophysiology of essential hypertension and it is hoped that it will be useful to researchers and clinicians with an interest in Essential hypertension.