Is the brain the essential in hypertension?

Area of Science:

• Neuroscience
• Cardiovascular Research
• Hypertension Pathophysiology

Background:

• Hypertension is traditionally viewed as a disease primarily affecting the brain in its later stages, leading to conditions like stroke.
• Emerging research indicates the brain's involvement in the onset of high blood pressure and its susceptibility to early hypertensive changes.
• Neural control of the vasculature and kidneys are recognized etiological factors in essential hypertension.

Purpose of the Study:

• To review current research on the brain's role in the initiation and progression of essential hypertension.
• To explore the concurrent influences of hypertension-inducing factors on both the brain and peripheral vasculature.
• To highlight the impact of early-stage hypertension on cognitive function, cerebral blood flow, and brain structure.

Main Methods:

• Review of existing animal research on neural control mechanisms in hypertension.
• Inclusion of human behavioral studies and brain imaging data, including magnetic resonance imaging (MRI) Blood Oxygen Level-Dependent (BOLD) responses.
• Analysis of studies examining cognitive deficits and structural brain changes in early hypertension.

Main Results:

• Early hypertension is linked to cognitive deficits, altered cerebral blood flow, and reduced grey matter in specific brain regions.
• Hypertension treatment may be less effective in reversing brain aging and cortical changes.
• Normotensive individuals at risk for hypertension show different BOLD responses during psychological challenges compared to those not at risk.

Conclusions:

• The brain is implicated in the initiation of hypertension and is affected by early disease processes.
• Concurrent targeting of the brain and vasculature by hypertension-inducing factors is suggested.
• Further research is needed to elucidate the mechanisms underlying the early, concurrent influences of hypertension on the brain and vasculature.