A. Increase in Extra cellular matrix (ECM), smooth muscle proliferation
B. Vascular injury from malignant hypertension
C. Stress (haemodynamic, metabolic)
D. Increase in Permeability, leakage of plasma components
Choose the correct answer from the options given below :
Understanding Hypertensive Arteriolosclerosis Evolution
Pathologic hypertensive arteriolosclerosis involves changes in small arteries (arterioles) due to sustained high blood pressure. The evolution follows a specific sequence:
Sequence Breakdown
- C. Stress (haemodynamic, metabolic): The process begins with factors like sustained high blood pressure (hemodynamic stress) or other metabolic disturbances that affect blood vessels.
- D. Increase in Permeability, leakage of plasma components: This initial stress damages the vessel endothelium, making the arteriole walls more permeable. Plasma proteins, such as fibrinogen and lipoproteins, leak into the vessel wall.
- A. Increase in Extra cellular matrix (ECM), smooth muscle proliferation: The leakage and associated inflammatory response trigger smooth muscle cells within the vessel wall to proliferate and increase the production of extracellular matrix components. This leads to thickening of the vessel wall.
- B. Vascular injury from malignant hypertension: This represents the severe stage or a key feature of pathologic arteriolosclerosis, often seen in malignant hypertension. It involves significant damage like fibrinoid necrosis and 'onion-skinning' (laminated thickening) of the arteriole walls, resulting from the cumulative effects of the preceding steps.
Correct Sequence
Therefore, the correct sequence detailing the evolution of pathologic hypertensive arteriolosclerosis is:
- Stress (haemodynamic, metabolic) - C
- Increase in Permeability, leakage of plasma components - D
- Increase in Extra cellular matrix (ECM), smooth muscle proliferation - A
- Vascular injury from malignant hypertension - B
The sequence is C, D, A, B.
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