Is the brain the essential in hypertension?
Is the brain the essential in hypertension?
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DOI：
10.1016/j.neuroimage.2009.04.072
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发表时间：
2009-09
期刊：
影响因子：
5.7
通讯作者：
Zanstra, Ydwine
中科院分区：
文献类型：
--
作者：
Jennings, J. Richard;Zanstra, Ydwine
关键词：
由于高血压患者中卒中的高患病率，脑通常被认为是晚期高血压疾病的靶点。然而，研究回顾表明，大脑与高血压的发生有关，并且本身也会因早期疾病过程而改变。大量文献将血管和肾脏的神经控制确定为原发性高血压的候选病因因素。这项研究主要是在动物身上进行的，现在又得到了人类行为和大脑成像研究的补充。这篇综述表明，脑和血管系统可能是原发性高血压诱发因素的独立和共同靶点。早期高血压与认知缺陷、改变的脑血流对认知处理的支持以及特定皮质区域的灰质减少有关。高血压的药物逆转在大脑过早老化的患者中不太成功，并且无法逆转大脑皮层内功能或结构变化的进展。此外，磁共振成像血氧水平依赖（BOLD）的反应，在心理挑战之间的血压正常的个人之间的风险和那些没有高血压的风险，因为他们夸大的血压反应心理挑战。需要进一步检查作用机制和疾病对大脑的早期影响，以了解对大脑和外周血管系统具有并发影响的病理生理机制。
The brain is typically considered a target for late stage hypertensive disease due to the high prevalence of stroke among hypertensive patients. Research is reviewed, however, that suggests that the brain is implicated in the initiation of high blood pressure and is itself altered by early disease processes. A substantial literature establishes neural control of the vasculature and kidney as candidate etiological factors in essential hypertension. This research, largely done in animals, is now supplemented by behavioral and brain imaging studies in humans. This review suggests that the brain and vasculature may be independently and concurrently targeted by the factors inducing essential hypertension. Early stage hypertension is associated with cognitive deficits, altered cerebral blood flow support for cognitive processing, and decreased grey matter in specific cortical regions. Pharmacological reversal of hypertension is less successful in patients with premature brain aging and fails to reverse either the progression of functional or structural changes within the cerebral cortex. Furthermore, magnetic resonance imaging Blood Oxygen Level-Dependent (BOLD) responses during psychological challenge differ between normotensive individuals at risk and those not at risk for hypertension because of their exaggerated blood pressure responses to psychological challenge. Further examination of mechanisms of action and early influences of the disease on the brain are required to understand the pathophysiological mechanisms having concurrent influences on the brain and the peripheral vasculature.
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影响因子：
5.7
作者：
Gianaros, Peter J.;Greer, Phil J.;Jennings, J. Richard
通讯作者：
Jennings, J. Richard
DOI：
10.1046/j.1440-1681.2001.03566.x
发表时间：
2001-12-01
影响因子：
2.9
作者：
Esler, M;Rumantir, M;Lambert, G
通讯作者：
Lambert, G
DOI：
10.1046/j.1365-201x.2003.01089.x
发表时间：
2003-03-01
期刊：
ACTA PHYSIOLOGICA SCANDINAVICA
影响因子：
--
作者：
Esler, M;Lambert, G;Kaye, D
通讯作者：
Kaye, D
影响因子：
8.3
作者：
Beason-Held, Lori L.;Moghekar, Abhay;Resnick, Susan M.
通讯作者：
Resnick, Susan M.
影响因子：
5.4
作者：
Efimova, Irina Yu.;Efimova, Nataliya Yu.;Lishmanov, Yuri B.
通讯作者：
Lishmanov, Yuri B.