The brain and hypertension: reflections on 35 years of inquiry into the neurobiology of the circulation.
In 1948 knowledge of the role of the central nervous system in controlling blood pressure was rudimentary and the possibility that the brain could contribute to hypertension was barely acknowledged. Over the past 35 years the development of new technologies, particularly those of the neurosciences, and their application to cardiovascular medicine have markedly increased our understanding of how the brain governs the circulation. Notable has been the increase in knowledge of the neuroanatomy, neurochemistry, and physiology of the representation, within the brain, of the pathways critical in governing blood pressure, particularly those involved in tonic and baroreflex control of the circulation. The observation that perturbations in these networks can lead to the development of hypertension or the reversal of established hypertension and the demonstration that some of these networks are targets of drugs used in the clinical treatment of hypertension provide obvious clinical relevance to the discoveries. In the future, it is expected that more will be discovered about the biochemical neuroanatomy, and hopefully the molecular biology, of these neuronal networks. Such advances will permit more rigorous testing of the proposition that defects in these systems may underlie the disorder of hypertension in human beings.
D001794:Blood Pressure; D001921:Brain / Q000033:anatomy & histology / Q000378:metabolism / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology; D002540:Cerebral Cortex; D004594:Electrophysiology; D049673:History, 20th Century; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000266:history / Q000473:pathology / Q000503:physiopathology*; D008526:Medulla Oblongata / Q000503:physiopathology; D009434:Neural Pathways; D011311:Pressoreceptors / Q000503:physiopathology; D012018:Reflex; D013116:Spinal Cord; D013315:Stress, Psychological / Q000503:physiopathology; D014666:Vasomotor System / Q000503:physiopathology