[Hypertension].

Abstract

As it is well known, hypertension is one of common diseases in civilized countries. Since essential hypertension is closely associated with our life style, it is called as one of "life style diseases". However, it is also evident that essential hypertension is an inherited familial disease, and evidence of the candidate genes has been accumulating. Point mutation of a single gene can cause hypertension as evidenced by the discovery in Liddle's syndrome, glucocorticoid remediable hyperaldosteronism, and an apparent mineral corticoid-excess syndrome. However, multiple anomalies of genes seem to be involved in essential hypertension. Even though the definite cause of hypertension is a genetic disorder, life style modification can prevent development of essential hypertension. Supplementation of potassium and/or suppression of sodium intake are effective for treatment of hypertension. In contrast, supplementation of sodium salt causes hypertension. Thereby, renal function to excrete sodium plays a key role, which is regulated by sympathetic nervous system activity via the renal nerves. The sympathetic activation is triggered by sodium loading, which may be mediated via releases of endogenous digitalis-like factors from the hypothalamus. Development of novel laboratory tests provides accurate diagnosis of pathophysiology of hypertension. The mechanism of essential hypertension is thus getting to be clear, which has led to the ideal treatment of hypertensive individuals. This article reviews the recent development in understanding of pathophysiology, laboratory tests, and treatment of hypertension.