Abstract
Maintenance of BP requires the coordinated regulation of many components that interact in an interdependent network that ultimately controls the main determinants of BP, cardiac output, peripheral resistance, and blood volume. Neurohumoral and autonomic mechanisms are key components of a complex network. The central nervous system, organized into multiple levels of integrative centers, regulates sympathetic activity and vasopressin release in response to nervous and humoral input. The autonomic system, by means of the efferent sympathetic and parasympathetic pathways, regulates heart rate, vasoconstriction, and activation of the renin-angiotensin-aldosterone system. Humoral components, angiotensin II, aldosterone, and atrial natriuretic peptides regulate vasoconstriction and sodium excretion. Short-term regulation of cardiac output and peripheral resistance is interconnected by autonomic nervous system reflexes with the intervention of baroreceptors. Mid-term control is achieved by the interplay between sympathetic nervous traffic, humoral systems, and the kidney, controlling vascular peripheral resistance and blood volume. The kidney, through both pressure-natriuresis and arteriolar mechanisms, as well as by flow-mediated vasodilatation and myogenic reactivity, participates broadly in the process. Finally, a circadian rhythm of BP levels is regulated by a clock mechanism driven by the suprachiasmatic nucleus, which is stimulated directly by light. Advances in molecular biology techniques and genetic experimental models continue to provide more precise information about these complex networks.
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Abbreviations
- ACE1:
-
Angiotensin-converting enzyme 1
- ACE2:
-
Angiotensin-converting enzyme 2
- ACh:
-
Acetylcholine
- ADMA:
-
Asymmetric dimethylarginine
- ALD:
-
Aldosterone
- Ang I:
-
Angiotensin I
- Ang I–7:
-
Angiotensin 1–7
- Ang II:
-
Angiotensin II
- Ang III:
-
Angiotensin III
- Ang IV:
-
Angiotensin IV
- AngIVr:
-
Angiotensin IV receptor
- ANGN:
-
Angiotensinogen
- ANP:
-
Atrial natriuretic peptide
- ANS:
-
Autonomic nervous system
- Apr:
-
Apelin receptor
- AS:
-
Apelinergic system
- AT1r:
-
AT1-receptor
- AT2r:
-
AT2-receptor
- BNP:
-
Brain natriuretic peptide
- BP:
-
Blood pressure
- CNP:
-
C-type natriuretic peptide
- CNS:
-
Central nervous system
- CV:
-
Circadian variability
- CVLM:
-
Caudal ventrolateral medulla
- DMV:
-
Dorsal motor nucleus of the vagus
- eNOS:
-
Nitric oxide synthase
- EP:
-
Epinephrine
- ErB:
-
Endothelin receptor B
- GABA:
-
Gamma-aminobutyric acid
- ILM:
-
Intermediate lateral medulla
- MCA4R:
-
Melanocortin
- MR:
-
Mineralocorticoid receptor
- NA:
-
Nucleus ambiguus
- NEP:
-
Norepinephrine
- NO :
-
Nitric oxide
- NOX:
-
NADPH oxidase
- NPRA :
-
Natriuretic peptide receptor A
- NPRB:
-
Natriuretic peptide receptor B
- NTS:
-
Nucleus of tractus solitarius
- OVLT:
-
Organum vasculosum of the lamina terminalis
- PRR:
-
Prorenin receptor
- PSN:
-
Parasympathetic nucleus
- PVN:
-
Paraventricular nucleus
- RAAS:
-
Renin-angiotensin-aldosterone system
- RGS:
-
Regulator of G protein signaling
- RVLM:
-
Rostral ventrolateral medulla
- SNA:
-
Sympathetic nervous activity
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Lurbe, E., Redon, J. (2023). Neurohumoral and Autonomic Regulation of Blood Pressure. In: Flynn, J.T., Ingelfinger, J.R., Brady, T.M. (eds) Pediatric Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-031-06231-5_1
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