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The study included 70 participants: 11 with pheochromocytoma, 13 with primary aldosteronism, and 17 with renovascular hypertension; 13 normotensive subjects and 16 patients with essential hypertension served as controls. All subjects were submitted to a biopsy of subcutaneous fat. Small resistance arteries were dissected and mounted on a micromyograph, and media-lumen ratio, media thickness, remodeling index, and growth index were evaluated. Endothelial function was evaluated according to the dose-response curve to acetylcholine. In patients with either primary aldosteronism or renovascular hypertension, a marked increase in media-lumen ratio was observed, whereas in patients with pheochromocytoma, the extent of vascular structural alterations was similar to that observed in patients with essential hypertension. The increase in media-lumen ratio in patients with essential hypertension and with pheochromocytoma was mainly due to vascular remodeling (remodeling index, 93% to 94%), whereas in patients with renovascular hypertension, there was vascular growth (remodeling index, 70%; growth index, 53%). Patients with primary aldosteronism had an intermediate pattern compared with the other two forms of secondary hypertension. An evident impairment of endothelial function was observed in all four hypertensive groups. In conclusion, the renin-angiotensin-aldosterone system seems to be more powerful than the adrenergic system in inducing vascular growth.<\/jats:p>","DOI":"10.1161\/01.hyp.28.5.785","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:53:46Z","timestamp":1339462426000},"page":"785-790","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":201,"title":["Vascular Hypertrophy and Remodeling in Secondary Hypertension"],"prefix":"10.1161","volume":"28","author":[{"given":"Damiano","family":"Rizzoni","sequence":"first","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo","family":"Porteri","sequence":"additional","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Castellano","sequence":"additional","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Bettoni","sequence":"additional","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lorenza","family":"Muiesan","sequence":"additional","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Muiesan","sequence":"additional","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano Maria","family":"Giulini","sequence":"additional","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Agabiti-Rosei","sequence":"additional","affiliation":[{"name":"the Chair of Semeiotica and Metodologia Medica, Department of Medical Sciences (D.R., E.P., M.C., G.B., M.L.M., E.A.-R.), and Chair of Chirurgia Generale, Department of Surgical Sciences (P.M., S.M.G.), University of Brescia (Italy)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.8.3.181"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1990.70.4.921"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Schiffrin EL. 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