Hypertension: CNS as a major player

A number of investigators have zeroed in on the brain as the culprit organ in hypertension.  I'll highlight a few of them here.  First, Marvar et al,  described how ablating the anteroventral third ventricle (AV3V) mechanically results in complete protecting from angiotensin-induced hypertension in mice. These regions of the brain are part of the circumventricular organs and are located adjacent to the cerebral ventricles and have a poorly formed blood-brain barrier allowing the neurons to communicate with hormones produced systemically such as angiotensin II. Young et al. recently reported an interesting finding that implicated endoplasmic reticulum stress in the brain subfornical organ (another circumventricular organ). Both of these studies are intriguing and underscore the complexity of hypertension and potentially new therapeutics for treatment down the line. This also underscores how the CNS can modulate effector organs, such as the renal nerves, to impact blood pressure.


Matthew Sparks, MD