Central mineralocorticoid receptors, sympathetic activity, and hypertension

Recent evidence highlighting the presence of cortico-steroid receptors in the central nervous system has prompted further investigation regarding their role in the pathogenesis of hypertension. The sympathetic nervous system, an important factor in the pathogenesis of hypertension, is influenced by sodium and volume status. Activation of central nervous system mineralocorticoid receptors is known to affect sympathetic activity, although the processes that underpin this phenomenon are incompletely understood. This article reviews some of the recent advances in this area, particularly mechanisms by which the mineralo-corticoid receptor maintains selectivity for its ligand within the central nervous system, its role in salt appetite, and the possibility of local production of corticosteroids. In addition, the links between central mineralocorticoid receptor activation, stress, sympathetic activity, and hypertension are discussed.