Chronic hypertension is associated with which form of arteriolosclerosis due to plasma protein leakage into vessel walls?

• A. Hyperplastic Arteriolosclerosis
• B. Atherosclerosis
• C. Monckeberg Medial Sclerosis
• D. Hyaline Arteriolosclerosis

Answer: (D)

Chronic hypertension injures small vessels, causing plasma proteins to leak into the arteriolar walls. This leakage leads to deposition of pink, hyaline material and increased basement membrane material, producing a homogeneous, thickened arteriolar wall with a narrowed lumen. The resulting hyaline arteriolosclerosis is characteristic of long-standing pressure overload and contributes to ischemic changes in organs, especially the kidney (benign nephrosclerosis) and retina. This pattern is distinct from hyperplastic arteriolosclerosis, which shows onion-skinning from smooth muscle hyperplasia in malignant hypertension; from Monckeberg medial sclerosis, which is calcification of the media in larger arteries; and from atherosclerosis, which involves lipid-rich plaques in larger arteries rather than arterioles.