[Pathogenic mechanism of primary hypertension].

Blood pressure is controlled by baroreceptor reflex and pressure natriuresis which consists of renal blood flow autoregulation and tubuloglomerular feedback loop. The tissue renin-angiotensin system in the kidneys contributes to the sensitivity of pressure natriuresis, and the sympathetic nervous activity further affects the tissue renin-angiotensin system in the kidneys and baroreceptor reflex. Moreover, the brain renin-angiotensin system enhances the sympathetic nervous activity. It is therefore likely that the brain renin-angiotensin system plays a pivotal role in the pathogenesis of primary hypertension. Recent studies showed that the expression levels of (pro) renin receptor increase in the brain of hypertensive rats, and that knocking down (pro) renin receptor expression leads to normalization of blood pressure. Because the (pro)renin receptor is known to regulate the tissue renin-angiotensin system, brain (pro) renin receptor may be a novel therapeutic target for primary hypertension.