情绪压力相关高血压的神经源背景。

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Current Hypertension Reports Pub Date : 2023-07-01 Epub Date: 2023-04-14 DOI:10.1007/s11906-023-01235-7
Marco Antônio Peliky Fontes, Fernanda Ribeiro Marins, Tapan A Patel, Cristiane Amorim de Paula, Liliane Ramos Dos Santos Machado, Érick Bryan de Sousa Lima, Ana Caroline Ventris-Godoy, Ana Clara Rocha Viana, Isadora Cristina Souza Linhares, Carlos Henrique Xavier, Jessica A Filosa, Kaushik P Patel
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引用次数: 0

摘要

综述的目的:对自然压力源的反应包括心脏刺激和血管变化,主要由交感神经活动的增加引发。这些效应会立即导致血流重新分配,为优先目标器官提供新陈代谢支持,并结合其他关键生理反应和认知策略,以应对压力挑战。这种经过数百万年进化而形成的精心策划的反应目前正在短时间内受到挑战。在这篇短文中,我们将讨论情绪压力诱发高血压的神经源背景,重点是人类和动物的相关研究结果中的交感神经通路:城市环境提供了各种心理压力。真实的或预期的情绪压力可能会增加交感神经的基线活动。从日常的交通压力到与工作有关的焦虑,情绪压力引起的交感神经活动的长期或异常增加可导致心血管事件,包括心律失常、血压升高甚至猝死。在提出的各种改变中,慢性压力可能会改变神经胶质细胞回路或损害抗氧化系统,从而改变神经元对压力刺激的反应能力。这些现象会导致交感神经活动增加、高血压以及随之而来的心血管疾病。焦虑、情绪压力和高血压之间的联系可能源于控制交感神经活动的中枢通路中神经元发射率的改变。神经胶质细胞和氧化机制参与了神经元功能的改变,这主要涉及交感神经外流的增强。本文讨论了岛叶皮层-背内侧下丘脑通路在交感神经整体外流增强演变过程中的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Neurogenic Background for Emotional Stress-Associated Hypertension.

Neurogenic Background for Emotional Stress-Associated Hypertension.

Neurogenic Background for Emotional Stress-Associated Hypertension.

Neurogenic Background for Emotional Stress-Associated Hypertension.

Purpose of review: The response to natural stressors involves both cardiac stimulation and vascular changes, primarily triggered by increases in sympathetic activity. These effects lead to immediate flow redistribution that provides metabolic support to priority target organs combined with other key physiological responses and cognitive strategies, against stressor challenges. This extremely well-orchestrated response that was developed over millions of years of evolution is presently being challenged, over a short period of time. In this short review, we discuss the neurogenic background for the origin of emotional stress-induced hypertension, focusing on sympathetic pathways from related findings in humans and animals.

Recent findings: The urban environment offers a variety of psychological stressors. Real or anticipatory, emotional stressors may increase baseline sympathetic activity. From routine day-to-day traffic stress to job-related anxiety, chronic or abnormal increases in sympathetic activity caused by emotional stressors can lead to cardiovascular events, including cardiac arrhythmias, increases in blood pressure and even sudden death. Among the various alterations proposed, chronic stress could modify neuroglial circuits or compromise antioxidant systems that may alter the responsiveness of neurons to stressful stimuli. These phenomena lead to increases in sympathetic activity, hypertension and consequent cardiovascular diseases. The link between anxiety, emotional stress, and hypertension may result from an altered neuronal firing rate in central pathways controlling sympathetic activity. The participation of neuroglial and oxidative mechanisms in altered neuronal function is primarily involved in enhanced sympathetic outflow. The significance of the insular cortex-dorsomedial hypothalamic pathway in the evolution of enhanced overall sympathetic outflow is discussed.

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来源期刊
Current Hypertension Reports
Current Hypertension Reports 医学-外周血管病
CiteScore
10.50
自引率
0.00%
发文量
65
审稿时长
6-12 weeks
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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