For decades, managing blood pressure has largely focused on achieving a specific number. But emerging research suggests that how blood pressure changes throughout the day – its variability – is just as critical for cardiovascular health. Now, a team at the University of Virginia School of Medicine has pinpointed a group of nerve cells in the brainstem that appear to act as a natural stabilizer, preventing dangerous fluctuations even during everyday activities.
Excessive short-term blood pressure variability is increasingly recognized as a strong and independent predictor of serious health issues, including heart disease, stroke, and even brain injury, according to researchers. This new discovery offers a potential pathway to treatments that don’t just lower blood pressure, but maintain its stability, potentially offering a more comprehensive approach to cardiovascular care.
The research, published in Circulation Research, reveals that these specialized nerve cells within the brainstem play a crucial role in buffering against blood pressure swings as the body transitions between states like sleeping, waking, standing, and exercising. “What we found is that a loss of just a few hundred nerve cells leads to unstable blood pressure even though the mean blood pressure was normal,” explained Stephen Abbott, PhD, lead investigator of the study and a UVA professor of pharmacology. “This shows that the system that keeps blood pressure steady from moment to moment is no longer working.”
The brainstem, a vital region controlling automatic functions like breathing and heart rate, contains these previously unidentified nerve cells that act as a critical regulatory system. The team’s work demonstrates that these cells help maintain consistent blood pressure by responding to the body’s changing needs.
Connection to Neurological Disorders
Interestingly, the loss or dysfunction of these same brain cells has already been observed in individuals with multiple system atrophy (MSA), a rare and fatal neurological disease closely related to Parkinson’s disease. MSA is characterized by severe blood pressure problems, and this finding suggests a potential link between the brain-based mechanisms identified in the UVA study and the instability seen in MSA patients. This connection opens the possibility that similar disruptions in these nerve cells could contribute to blood pressure fluctuations in other conditions where average blood pressure readings appear normal, but patients still experience cardiovascular issues.
The researchers emphasize that this shifts the focus of blood pressure management. “Our work emphasizes a new appreciation for how we suppose about blood pressure problems,” Abbott said. “It’s not just about lowering the numbers – it’s about keeping blood pressure stable from moment to moment.”
Research Team and Funding
The research team included George M.P.R. Souza, Harsha Thakkalapally, Faye E. Berry, Leah F. Wisniewski, Ulrich M. Atongazi, Daniel S. Stornetta, and Abbott. The study was supported by the National Institutes of Health through grant HL148004. The scientists involved report no financial conflicts of interest.
This research aligns with the mission of UVA’s Paul and Diane Manning Institute of Biotechnology, which aims to accelerate the translation of laboratory discoveries into new treatments for complex medical conditions. The institute focuses on bridging the gap between basic science and clinical application, potentially expediting the development of therapies based on these findings.
Implications for Future Treatments
While still in its early stages, this research offers a promising new avenue for developing treatments that target blood pressure variability. Future studies will focus on understanding the precise mechanisms by which these brainstem nerve cells function and how their dysfunction contributes to cardiovascular disease. The ultimate goal is to identify ways to restore or enhance the stabilizing function of these cells, potentially offering a more effective approach to preventing heart attacks, strokes, and other related health problems.
The discovery underscores the importance of considering the dynamic nature of blood pressure, rather than solely focusing on static measurements. As research continues, a more nuanced understanding of blood pressure regulation could lead to personalized treatment strategies tailored to individual needs and risk factors.
Disclaimer: This article provides informational content and should not be considered medical advice. Please consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
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