This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Vasculitis, Subject name: Pathology
A 60-year-old man presents with dizziness, nausea and severe shoness of breath of several months' duration. Physical examination shows hepatomegaly, ascites and anasarca. His blood pressure is 200/115 mm Hg. An X-ray film of the chest demonstrates cardiomegaly and mild pulmonary edema. Although different mechanisms may have contributed to the pathogenesis of hypeension in this patient, the common end result for all of them is which of the following? 
Select and explain. 
A. Aerial cystic medial necrosis, B. Decreased plasma oncotic pressure, C. Generalized vasodilation, D. Increased peripheral vascular resistance
D: Increased peripheral vascular resistance
Answer: D: Increased peripheral vascular resistance 
Explanation: In patients with systemic hypeension, the end result of autoregulation is always increased peripheral resistance. Most cases of hypeension represent an imbalance between renal function and sodium homeostasis. In this context, the renin-angiotensin system increases blood pressure, whereas this axis is antagonized by atrial natriuretic factor. Cystic medial necrosis is a factor in aoic dissecting aneurysm. Vasodilation decreases blood pressure. Decreased plasma oncotic pressure may be a consequence of uncontrolled hypeension, but does not cause it.