Hypertension is defined by an increase in systemic blood pressure above limits considered normal, currently set at 140 mmHg for systolic and 90 mmHg for diastolic pressure. Assuming central venous pressure to be near zero, mean arterial pressure is determined by the product of total peripheral resistance and cardiac output. In most cases of essential hypertension, as well as in animal models of hypertension, cardiac output and its main determinants, stroke volume and heart rate, are normal, whereas total peripheral resistance is increased. Total peripheral resistance is influenced by a number of factors described by the Poiseuille’s law, the most significant of which by far is the diameter of blood vessels of the arterial tree. Since blood vessel diameter is a reflection of both vascular structure and active regulation of vascular tone through mechanisms of vasoconstriction and vasodilatation, it is generally considered that alterations in total peripheral resistance are directly determined by alterations in vascular smooth muscle structure and/or function. Thus, complex blood pressure regulation systems, including renal, nervous, endocrine, immune, and others, in their turn influenced by genetic or environmental factors, converge upon the same molecular mechanisms that control the structure and function of vascular smooth muscle. In this work, rather than providing the exhaustive list of modifications in the blood pressure regulating systems that ultimately affect the vasculature in hypertension, we will focus on the structural and functional alterations of vascular smooth muscle per se during hypertension.
The Book takes the approach of a critique of the prevailing international environmental law-making processes and their systemic shortcomings. It aims to partly redesign the current international environmental law-making system in order to promote further legislation and more effectively protect the natural environment and public health. Through case studies and doctrinal analyses, an array of initial questions guides the reader through a variety of factors influencing the development of International Environmental Law. After a historical analysis, commencing from the Platonic philosophy up to present, the Book holds that some of the most decisive factors that could create an optimized law-making framework include, among others: progressive voting processes, science-based secondary international environmental legislation, new procedural rules, that enhance the participation in the law-making process by both experts and the public and also review the implementation, compliance and validity of the science-base of the laws. The international community should develop new law-making procedures that include expert opinion. Current scientific uncertainties can be resolved either by policy choices or by referring to the so-called „sound science.“ In formulating a new framework for environmental lawmaking processes, it is essential to re-shape the rules of procedure, so that experts have greater participation in those, in order to improve the quality of International Environmental Law faster than the traditional processes that mainly embrace political priorities generated by the States. Science serves as one of the main tools that will create the next generation of International Environmental Law and help the world transition to a smart, inclusive, sustainable future.
Hypertension is defined by an increase in systemic blood pressure above limits considered normal, currently set at 140 mmHg for systolic and 90 mmHg for diastolic pressure. Assuming central venous pressure to be near zero, mean arterial pressure is determined by the product of total peripheral resistance and cardiac output. In most cases of essential hypertension, as well as in animal models of hypertension, cardiac output and its main determinants, stroke volume and heart rate, are normal, whereas total peripheral resistance is increased. Total peripheral resistance is influenced by a number of factors described by the Poiseuille’s law, the most significant of which by far is the diameter of blood vessels of the arterial tree. Since blood vessel diameter is a reflection of both vascular structure and active regulation of vascular tone through mechanisms of vasoconstriction and vasodilatation, it is generally considered that alterations in total peripheral resistance are directly determined by alterations in vascular smooth muscle structure and/or function. Thus, complex blood pressure regulation systems, including renal, nervous, endocrine, immune, and others, in their turn influenced by genetic or environmental factors, converge upon the same molecular mechanisms that control the structure and function of vascular smooth muscle. In this work, rather than providing the exhaustive list of modifications in the blood pressure regulating systems that ultimately affect the vasculature in hypertension, we will focus on the structural and functional alterations of vascular smooth muscle per se during hypertension.
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