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  • Review Article
  • Review Series: Basic science in hypertension research
  • Published:

Clarification of hypertension mechanisms provided by the research of central circulatory regulation

Hypertension Research volume 46, pages 1908–1916 (2023)Cite this article

Abstract

Sympathoexcitation, under the regulatory control of the brain, plays a pivotal role in the etiology of hypertension. Within the brainstem, significant structures involved in the modulation of sympathetic nerve activity include the rostral ventrolateral medulla (RVLM), caudal ventrolateral medulla (CVLM), nucleus tractus solitarius (NTS), and paraventricular nucleus (paraventricular). The RVLM, in particular, is recognized as the vasomotor center. Over the past five decades, fundamental investigations on central circulatory regulation have underscored the involvement of nitric oxide (NO), oxidative stress, the renin-angiotensin system, and brain inflammation in regulating the sympathetic nervous system. Notably, numerous significant findings have come to light through chronic experiments conducted in conscious subjects employing radio-telemetry systems, gene transfer techniques, and knockout methodologies. Our research has centered on elucidating the role of NO and angiotensin II type 1 (AT1) receptor-induced oxidative stress within the RVLM and NTS in regulating the sympathetic nervous system. Additionally, we have observed that various orally administered AT1 receptor blockers effectively induce sympathoinhibition by reducing oxidative stress via blockade of the AT1 receptor in the RVLM of hypertensive rats. Recent advances have witnessed the development of several clinical interventions targeting brain mechanisms. Nonetheless, Future and further basic and clinical research are needed.

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Acknowledgements

A Grant-in-Aid for Scientific Research supported this study from the Japan Society for the Promotion of Science (15590757, 17590745, 19390231, and 22790709) and, in part, a Kimura Memorial Foundation Research Grant. I want to appreciate Prof. Yoshitaka Hirooka, Kenji Sunagawa, and Akira Takeshita significantly. Furthermore, I express special thanks to Satomi Konno.

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  1. Department of Graduate School of Medicine (Cardiology), International University of Health and Welfare, Okawa, Japan

    Takuya Kishi

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Kishi, T. Clarification of hypertension mechanisms provided by the research of central circulatory regulation. Hypertens Res 46, 1908–1916 (2023). https://doi.org/10.1038/s41440-023-01335-6

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