Figure 14. Proposed pathway.

Chronic vascular oxidative stress leads to formation of immunogenic isoketal-protein adducts, which accumulate in DCs and promote T cell activation. Activated T cells accumulate in perivascular tissues and release cytokines that enhance collagen deposition and aortic stiffening. This enhances pulse wave velocity. Renal inflammation and fibrosis follows these events, leading to overt hypertension.