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The roles of sensitization and neuroplasticity in the long-term regulation of blood pressure and hypertension
Journal article   Open access   Peer reviewed

The roles of sensitization and neuroplasticity in the long-term regulation of blood pressure and hypertension

Alan Kim Johnson, Zhongming Zhang, Sarah C Clayton, Terry G Beltz, Seth W Hurley, Robert L Thunhorst and Baojian Xue
American journal of physiology. Regulatory, integrative and comparative physiology, Vol.309(11), pp.R1309-R1325
12/01/2015
DOI: 10.1152/ajpregu.00037.2015
PMCID: PMC4698407
PMID: 26290101
url
https://doi.org/10.1152/ajpregu.00037.2015View
Published (Version of record) Open Access

Abstract

After decades of investigation, the causes of essential hypertension remain obscure. The contribution of the nervous system has been excluded by some on the basis that baroreceptor mechanisms maintain blood pressure only over the short term. However, this point of view ignores one of the most powerful contributions of the brain in maintaining biological fitness-specifically, the ability to promote adaptation of behavioral and physiological responses to cope with new challenges and maintain this new capacity through processes involving neuroplasticity. We present a body of recent findings demonstrating that prior, short-term challenges can induce persistent changes in the central nervous system to result in an enhanced blood pressure response to hypertension-eliciting stimuli. This sensitized hypertensinogenic state is maintained in the absence of the inducing stimuli, and it is accompanied by sustained upregulation of components of the brain renin-angiotensin-aldosterone system and other molecular changes recognized to be associated with central nervous system neuroplasticity. Although the heritability of hypertension is high, it is becoming increasingly clear that factors beyond just genes contribute to the etiology of this disease. Life experiences and attendant changes in cellular and molecular components in the neural network controlling sympathetic tone can enhance the hypertensive response to recurrent, sustained, or new stressors. Although the epigenetic mechanisms that allow the brain to be reprogrammed in the face of challenges to cardiovascular homeostasis can be adaptive, this capacity can also be maladaptive under conditions present in different evolutionary eras or ontogenetic periods.
 Adaptation, Physiological Genetic Predisposition to Disease Central Nervous System - metabolism Angiotensin II - metabolism Signal Transduction Blood Pressure - genetics Humans Risk Factors Cardiovascular System - innervation Heredity Hypertension - physiopathology Hypertension - etiology Hypertension - metabolism Aldosterone - metabolism Animals Renin-Angiotensin System Time Factors Neuronal Plasticity Central Nervous System - physiopathology Hypertension - genetics Hypertension - diagnosis Disease Models, Animal

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