Humoral factors in the etiopathogenesis of arterial hypertension.

On the basis of a critical analysis of the literature and of his own results, the author submits a survey of the role of humoral factors in the etiopathogenesis of the various types of arterial hypertension. The role of pressor and depressor factors in the pathogenesis of hypertension must be comprehended in close association with the other, non-humoral mechanism of blood pressure regulation. Hypertension can develop as a result of hyperactivity of one or more factors of pressor systems, including the sympathoadrenal system, the renin-angiotensin system and mineralocorticoids, or of reduced activity of one or more components of depressor systems, i.e. prostaglandins and the kallikrein-kinin system. In recent years increased attention has been paid to monoaminergic and peptidergic transmitters of nerve impulses in the CNS and at the periphery, to the role of the natriuretic factor and to anomalies of mechanisms of sodium transport across the cell membrane. The role of the various mechanisms in the different types of arterial hypertension tends to vary and during the disease their share changes according to the stage of hypertension. In clinical practice examination of the activity of humoral factors can contribute to the differential diagnosis (particularly of secondary forms of hypertension) and to certain therapeutic decisions, but always in the context of the other clinical and laboratory findings.