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The pathophysiology of primary hypertension is heterogeneous,but ultimately exerts its effects through the two primarydeterminants of blood pressure: cardiac output and peripheralresistance. The processes influencing these two determinantsare numerous and complex (Fig. 2–2).9 The underlying causeof primary hypertension is unknown and most likely multifactorial.Although several hypotheses exist, we will limit ourdiscussion to a few while recognizing that only a minority ofpatients with hypertension may have an identifiable cause. Fora detailed discussion of the pathophysiology behind these secondarycauses, the reader is referred to additional texts.10,11Discussion of the management of patients with select secondarycauses are found elsewhere in this chapter.
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