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From Brain to Behavior: Hypertension's Modulation of Cognition and Affect

By J. Richard Jennings and Alicia F. Heim


Accumulating evidence from animal models and human studies of essential hypertension suggest that brain regulation of the vasculature is impacted by the disease. Human neuroimaging findings suggest that the brain may be an early target of the disease. This observation reinforces earlier research suggesting that psychological factors may be one of the many contributory factors to the initiation of the disease. Alternatively or in addition, initial blood pressure increases may impact cognitive and/or affective function. Evidence for an impact of blood pressure on the perception and experience of affect is reviewed vis-a-vis brain imaging findings suggesting that such involvement in hypertensive individuals is likely

Topics: Review Article
Publisher: Hindawi Publishing Corporation
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Provided by: PubMed Central

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  1. (2003). a n dD .A .R a y n o r ,“ C o r r e s p o n d e n c eb e t w e e nl a b o r a t o r y and ambulatory measures of cardiovascular reactivity: a multilevel modeling approach,”
  2. (2002). A quantitative review of prospective evidence linking psychological factors with hypertension development,”
  3. (2009). A review of neuroimaging studies of stressor-evoked blood pressure reactivity: emerging evidence for a brain-body pathway to coronary heart disease risk,”
  4. (2007). A short history of the study of hypertension,”
  5. (2008). A sympathetic view of the sympathetic nervous system and human blood pressure regulation,”
  6. (1984). Acute psychophysiologic reactivity and risk of cardiovascular disease: a review and methodologic critique,”
  7. (2008). Aging, arterial function, and systolic hypertension,” in Hypertension Primer,J .L .I z z o
  8. (2002). Alexithymia and cardiovascular risk in older adults: psychosocial, psychophysiological, and biomedical correlates,”PsychologyandHealth,vol.17,no.5,pp.597–610,
  9. (1995). Alexithymia in essential hypertensive and psychiatric outpatients: a comparative study,”
  10. (1999). Alexithymia: a facet of essential hypertension,”
  11. (2010). An angiotensin II type 1 receptor blocker can preserve endothelial function and attenuate brain ischemic damage in spontaneously hypertensive rats,”
  12. (1979). and T.G.Pickering,“Baroreceptoractivationreducesreactivityto noxious stimulation: implications for hypertension,”
  13. (2005). Anti-stress and anti-anxiety effects of centrally acting angiotensin II AT1 receptor antagonists,” Regulatory Peptides,
  14. (2009). Ascoli et al., “Does psychosocial stress cause hypertension? A systematic review of observational studies,”
  15. (2009). Attenuation of psotitive and negative affect in men and woeman at increased risk for hypertension: A function of endogenous barostimulation?”
  16. (2003). Autoregulation of blood pressure and thought: preliminary results of an application of brain imagingtopsychosomaticmedicine,”PsychosomaticMedicine,vol.
  17. (2009). B o u r a s s a ,A .F .S v e d ,a n dR .C .S p e t h ,“ A n g i o t e n s i n modulation of rostral ventrolateral medulla (RVLM) in cardiovascular regulation,” Molecular and Cellular Endocrinology,
  18. (1987). Behavioral consequences of hypertsnion and their relationship to personality,”
  19. (2010). Brain function, cognition, and the blood pressure response to pharmacological treatment,”
  20. (2008). Brain imaging findings predict blood pressure response to pharmacological treatment,”
  21. (2003). Brainstem mechanisms of hypertension: role of the rostral ventrolateral medulla,” Current Hypertension Reports,
  22. (2011). Cardiovascular emotional dampening: Blood pressure and recognition of emotion,”
  23. (2003). Cardiovascular reactivity and development of preclinical and clinical disease states,”
  24. (1994). Central effects of baroreceptor activation in humans: attenuation of skeletal reflexes and pain perception,”
  25. (2011). Central Regulation of Autonomic Function,
  26. (2008). Chronic mental stress is a cause of essential hypertension: presence of biological markers of stress,”
  27. (2005). Comparing extent of activation: a robust permutation approach,”
  28. (2000). Correction of arterial structure and endothelial dysfunction in human essential hypertension by the angiotensin receptor antagonist losartan,”
  29. (2010). D.M.Davydov,D.Shapiro,andI.B.Goldstein,“Relationship of resting baroreflex activity to 24-hour blood pressure and mood in healthy people,”
  30. (1999). Decreased pain perception and risk for hypertension: considering a common physiological mechanism,”
  31. (2003). Defensiveness and 3-year blood pressure levels among young adults: the mediating effect of stress-reactivity,”
  32. (2010). Differences in emotion processing in patients with essential and secondary hypertension,”
  33. (1971). Differences in perception between hypertensive and normotensive populations,”
  34. (1996). Elevated blood pressure and personality: a metaanalytic review,”
  35. (1999). Elevated blood pressure and self-reported symptom complaints, daily hassles, and defensiveness,”
  36. (1991). Emotion and Adaptation,
  37. (2010). Emotional and cognitive aspects of empathy and their relation to social cognition-an fMRI-study,”
  38. (2011). Emotional perception: meta-analyses of face and natural scene processing,”
  39. (1968). Emotions and adaptation: conceptual and empirical relations,”
  40. (2009). Essential hypertension: is there a role for inflammatory mechanisms?”
  41. (2008). Experimental models of hypertension,” in Hypertension Primer,J .L .I z z oJ r .
  42. (1943). F.Dunbar,“Criteriaforpsychosomaticdiagnosisandtherapy with special reference to cardiovascular syndromes,”
  43. (1995). Family history of hypertension influences neurobehavioral function in hypertensive patients,”
  44. (2000). From homeostasis to allodynamic regulation,”
  45. (2008). Functional grouping and cortical-subcortical interactions in emotion: a meta-analysis of neuroimaging studies,”
  46. (2010). Genome-wide association studies: contribution of genomics to understanding blood pressure and essential hypertension,” Current Hypertension Reports,
  47. (2009). Glucocorticoid signaling in the cell: expanding clinical implications to complex human behavioral and somatic disorders,”
  48. (2007). Heightened functional neural activation to psychological stress covaries with exaggerated blood pressure reactivity,”
  49. (2009). Heightened resting neural activity predicts exaggerated stressor-evoked blood pressure reactivity,”
  50. (2006). Higher blood pressure predicts lower regional grey matter volume: consequences on short-term information processing,”
  51. (1939). Hostility in cases of essential hypertension,”
  52. (2007). Hyperadrenergic and labile hypertension,”
  53. (2001). Hypertension and appraisal of physical and psychological stressors,”
  54. (1997). Hypertension and Stress: A Unified Concept, Lawrence Erlbaum Associates,
  55. (2003). Hypertension and the brain: vulnerability of the prefrontal regions and executive functions,”
  56. (1996). Hypertension andobjective andself-reportedstressorexposure: a review,”
  57. (2010). hypertension, and subclinical atherosclerosis in the general population,”
  58. I.Nyklicek,“Alexithymiafactorsandbloodpressurehyperreactivity to stressful tasks,”
  59. (2008). Individual differences in stressorevoked blood pressure reactivity vary with activation, volume, and functional connectivity of the amygdala,”
  60. (1996). Inpaired verbal and nonverbal emotion recognition in alexithymia,”
  61. (1997). Interactive effects of age and hypertension on volumes of brain structures,”
  62. Is the brain the essential in hypertension?”NeuroImage,vol.47,no.3,pp.914–921,2009.
  63. (2005). Is there a functional neural correlate of individual differences
  64. (2004). J.McMullen,“Elevatedrestingbloodpressureanddampened emotional response,”
  65. (2005). K.C.Light,“Environmentalandpsychosocialstressinhypertension onset and progression,” in Hypertension: A Companion to Brenner and Rector’s the Kidney, S. Oparil and M.
  66. (2009). L a n e ,K .M c R a e ,E .M .R e i m a n
  67. (2009). Leutgeb ,G.R eishofer ,F .Ebner ,andA.Schienle, “Propensity and sensitivity measures of fear and disgust are differentially related to emotion-specific brain activation,”
  68. (2002). McCubbin,“Therelationshipbetweenrestingbloodpressure and acute pain sensitivity in healthy normotensives and chronic back pain sufferers: the effects of opioid blockade,”
  69. (2008). Meltzer,“Cerebrovascularsupportforcognitiveprocessingin hypertensive patients is altered by blood pressure treatment,”
  70. (2009). Neural correlates of processing stressful information: an event-related fMRI study,”
  71. (2008). Neural correlates of visuospatial working memory in healthy young adults at risk for hypertension,”
  72. (2011). Neurobiological correlates of social exclusion and social pain,” in Embitterment: Societal,
  73. (2005). o h n s o n ,B .R o d r i g u e z - I t u r b e
  74. (2008). o h n s o n ,D .I .F e i g ,T .N a k a g a w a ,L .G .S a n c h e z ,a n d B.Rodriguez-Iturbe,“Pathogenesisofessentialhypertension: historical paradigms and modern insights,”
  75. (2006). Opioid analgesia in persons at risk for hypertension,”
  76. (2005). Pathophysiology of hypertension,” in Hypertension: A Companion to Brenner and Rector’s the Kidney,S .O p a r i la
  77. (1961). Personality and life history factors in persons who are potentially hypertensive,”
  78. (2005). Protective effect of the inhibition of the renin-angiotensin system on aging,” Regulatory Peptides,
  79. (1979). Psychobiology of Essential Hypertension,E l s e v i e r ,
  80. (1997). Psychophysiological reactivity of borderline hypertensives and their recovery after mental stress,”
  81. (2003). Psychophysiological reactivity: mechanismsandpathwaystocardiovasculardisease,”Psychosomatic
  82. (2010). Psychophysiological risk markers of cardiovascular disease,”
  83. (2006). Psychosocial, hemostatic, and inflammatory correlates of delayed poststress blood pressure recovery,”
  84. (2005). Psychosociol stress and cardiovascular risk: what is the role of daily experience?”
  85. (1950). Psychosomatic Medicine: Its Principles and Applications,W .W .N o r t o n&C o m p a n y ,N e wY o r k
  86. (2005). Reduced cerebral blood flow response and compensation among patientswithuntreatedhypertension,”Neurology,vol.64,no. 8,
  87. (2011). Regional grey matter shrinks in hypertensive individuals despite successful lowering of blood pressure,”
  88. (2011). Regulation of autonomic function by visceral and somatic afferents,” in Central Regulation of Autonomic Functions,I .J .L l e w e l l y n - S m i t ha n
  89. (2003). Relationship between blood pressure and Alzheimer’s disease in Linxian County,
  90. (1953). Response to psychologic stress in persons who are potentially hypertensive,”
  91. (1998). Resting blood pressure and thermal pain responses among females: effects on pain unpleasantness but not pain intensity,”
  92. Self-efficacy mechanism in human agency,”
  93. (1977). Self-efficacy: toward a unifying theory of behavioral change,” Psychological Review,v o l .8 4 ,n o .2 ,p p .
  94. (2011). Social pain: experiential, neurocognitive, andgeneticcorrelates,”inSocialNeuroscience:TowardUnderstanding the Underpinnings of the Social Mind,
  95. (2009). Stress-induced sodium retention and hypertension: a review and hypothesis,” Current Hypertension Reports,
  96. (2004). Stress, coping, and health outcomes among African-Americans: a review of the John Henryism hypothesis,”
  97. (1984). The effect of alexithymia on morbidity
  98. The mosaic theory 32 years later,”
  99. (1967). The mosaic theory of arterial hypertension—its interpretation,” Perspectives in
  100. (2011). The power of imagination—how anticipatory mental imagery alters perceptual processing of fearful facial expressions,” NeuroImage,v o l .5 4 ,n o .2 ,p p .
  101. (2006). The sympathetic control of blood pressure,”
  102. (2005). The sympathetic nervous system in acute and chronic blood pressure elevation,”
  103. (2011). The ventrolateral medulla and sympathetic regulation of arterial pressure,” in Central Regulation of Autonomic Functions,I .J .L l e w e l l y n - S m i t ha n d
  104. (1999). Theoretical review: altered pain regulatory systems
  105. (2003). Toward a causal model of cardiovascular responses to stress and the development of cardiovascular disease,”
  106. (2011). u b c e v i c ,H .W a k i ,M .K .R a i z a d a ,a n dJ
  107. (1995). u l s ,C .K .W a n ,a n dP .T .C o s t aJ r . ,“ R e l a t i o n s h i po fo f trait anger to resting blood pressure: a meta-analysis,”
  108. (2007). Vascular health and longitudinal changes in brain and cognitioninmiddle-agedandolderadults,”Neuropsychology,
  109. (2005). W a l d s t e i n ,P .P .G i g g e y ,J .F .T h a y e r ,a n dA .B . Zonderman, “Nonlinear relations of blood pressure to cognitive function: the Baltimore longitudinal study of aging,”
  110. (1991). W a l d s t e i n ,S .B .M a n u c k ,C .M .R y a n ,a n dM .F . Muldoon, “Neuropsychological correlates of hypertension: review and methodologic considerations,”

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