Hypertension III: Flow-Induced Vascular Remodeling

Re: Hypertension, shear stress, and endothelial dysfunction

Russell L. Prewitt

Dear Dr. Unthank:
 Thank you for your thoughtful comment.  By saying that the endothelial dysfunction is not pathological in this case I mean that it does not have a deleterious effect.  I agree with you that the setpoint is changed, but it results in normal blood flow in face of the higher driving pressure.  It therefore seems to be an adaptation to shift the autoregulatory curve to the right and as a result the arteriole maintains close to normal vascular tone and wall stress while controlling flow to the normal level.  
   You are also correct that this idea is still an hypothesis, but it explains a lot of data gathered from a variety of experiments.  

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