TNF and endothelial dysfunction: First, the chronic mechanical stress inherent to hypertension could lead to the injury of vascular endothelial cells, resulting in endothelial dysfunction and the secretion of pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), and chemokines like C-C motif chemokine ligand 2 (CCL2).