Endothelium, the Blood–Brain Barrier, and Hypertension

T. Michael De Silva; Ricardo A. Peña Silva; Frank M. Faraci

doi:10.1007/978-3-319-25616-0_8

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Book chapter

Endothelium, the Blood–Brain Barrier, and Hypertension

T. Michael De Silva, Ricardo A. Peña Silva and Frank M. Faraci

Hypertension and the Brain as an End-Organ Target, pp.155-180

Springer International Publishing

01/13/2016

DOI: 10.1007/978-3-319-25616-0_8

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Abstract

This chapter summarizes concepts regarding the effects of hypertension on the cerebral circulation. In relation to end-organ effects, the brain is one of the organs most significantly affected by chronic elevations in arterial pressure. Hypertension is a leading risk factor for cerebrovascular disease, stroke, and cognitive decline. Endothelial cells are a target of hypertension. These cells are normally key determinants of vascular tone, while also protecting against thrombosis and abnormal vascular growth. The impact of acute and chronic hypertension is outlined with emphasis on changes in the biology of the signaling molecule nitric oxide and the role that oxidative stress plays in these changes. The importance of NADPH oxidase and other mechanisms that promote oxidative stress are presented. As part of the discussion, there is an overview regarding vascular alterations in various genetic and pharmacological models of hypertension. Effects of the renin-angiotensin system and angiotensin-II are highlighted. Endothelial cells are also the site of the blood–brain barrier (BBB). The molecular organization of the BBB is summarized along with key changes that occur in response to acute and chronic hypertension. Lastly, the clinical impact of these changes is discussed.

Acute hypertension

Blood–brain barrier

Cerebral blood flow

Chronic hypertension

EDCF

Endothelial function

Oxidative stress

Details

Title: Subtitle: Endothelium, the Blood–Brain Barrier, and Hypertension
Creators: T. Michael De Silva - Roy J. and Lucille A. Carver College of Medicine
Ricardo A. Peña Silva - College of Medicine, Universidad de los Andes
Frank M. Faraci - Roy J. and Lucille A. Carver College of Medicine
Resource Type: Book chapter
Publication Details: Hypertension and the Brain as an End-Organ Target, pp.155-180
DOI: 10.1007/978-3-319-25616-0_8
Publisher: Springer International Publishing; Cham
Language: English
Date published: 01/13/2016
Academic Unit: Cardiovascular Medicine; Neuroscience and Pharmacology; Neurosurgery; Internal Medicine
Record Identifier: 9984303744002771

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