End-Organ Damage Mechanisms · USMLE Step 1

Which mechanism is fundamental in causing end-organ damage in chronic uncontrolled hypertension?

  1. Immune-complex deposition in capillaries
  2. High hemodynamic load injuring the endothelium
  3. Chronic viral infection of endothelial cells
  4. Deposition of urate crystals in the interstitium
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Correct answer: High hemodynamic load injuring the endothelium

Chronic hypertension imposes a high hemodynamic load on small vessels, injuring the endothelium and microcirculation and producing target-organ damage in the heart, kidney, brain, and vessels.

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