The vascular phenotype in hypertension

Hypertension is a common disorder and a major risk factor for cardiovascular disease. Underlying pathophysiological mechanisms include increased vascular resistance, determined primarily by endothelial dysfunction, vascular hyperreactivity, and arterial remodeling, features that characterize the vascular phenotype in hypertension. Myriad molecular processes and signaling pathways underlie the hypertensive vasculome including Ca2+ and Rho kinase signaling, oxidative stress, fibrosis, inflammation, cellular senescence, and vascular smooth muscle cell dedifferentiation. Additionally, perivascular adipose tissue modulates vascular function in hypertension through adipocyte-derived vasoactive factors that promote vascular contraction and inflammation. These processes are highly regulated. Dissecting the vasculome in hypertension will provide new insights into disease mechanisms, facilitating development of mechanism- and disease-specific therapies. Here we provide a comprehensive overview of the (patho)physiological processes that influence the vasculature and delineate molecular mechanisms that define the vasculome in hypertension, focusing on some new concepts related to vascular signaling, inflammation, perivascular adipose tissue, and aging.