Structure and function of neurovascular unit in arterial hypertension

Area of Science:

• Neuroscience
• Cerebrovascular Medicine
• Hypertension Research

Background:

• Arterial hypertension is a primary risk factor for cognitive impairment and stroke.
• While larger cerebral vessels adapt, chronic hypertension profoundly alters cerebral microcirculation structure and function.
• These alterations disrupt the neurovascular unit, causing endothelial dysfunction, blood-brain barrier issues, and impaired neurovascular coupling.

Purpose of the Study:

• To review the effects of chronic arterial hypertension on the neurovascular unit.
• To discuss the impact of hypertension on components crucial for neurovascular coupling.
• To highlight the link between hypertension-induced microcirculatory changes and cognitive decline.

Main Methods:

• Literature review of studies on chronic arterial hypertension and cerebral microcirculation.
• Analysis of research on the neurovascular unit components (endothelial cells, astrocytes, pericytes).
• Examination of the mechanisms of impaired neurovascular coupling in hypertension.

Main Results:

• Hypertension causes structural and functional changes in cerebral microvessels.
• Endothelial dysfunction, blood-brain barrier disruption, and impaired neurovascular coupling are key consequences.
• Impaired functional hyperemia due to dysregulated neurovascular coupling contributes to cognitive decline.

Conclusions:

• Chronic arterial hypertension detrimentally affects the neurovascular unit's components.
• Impaired neurovascular coupling is a critical mechanism linking hypertension to cognitive impairment and dementia.
• Understanding these effects is vital for developing therapeutic strategies against hypertension-related neurological disorders.