Figure 1.

Pathological mechanisms of arterial wall remodelling. High blood pressure, by different stimuli, promotes several changes in the vessel wall of both large and small arteries, including recruitment and infiltration of inflammatory cells into the vessel wall, release of free radicals, proinflammatory chemokines, and cytokines, changes in vascular smooth muscle cells (VSMCs) (↑ cells hyperplasia and migration, ↑ VSMCs contraction and ↓ VSMCs relaxation, cells differentiation into osteogenic phenotype), endothelial cells (cells differentiation into osteogenic and VSMCs phenotype), elastic fiber degradation, collagen deposition, and calcification. The activity of several matrix metalloproteinases (MMPs) increases thereby contributing to development of arterial stiffness. Adapted from Van Varik BJ, et al. Mechanisms of arterial remodeling: Lessons from genetic diseases. Front Genet. 2012;3:290.  © 2012 van Varik, Rennenberg, Reutelingsperger, Kroon, de Leeuw and  Schurgers. This is an open-access article distributed under the terms of the Creative Commons Attribution License http://https://creativecommons.org/licenses/by/3.0/legalcode.33