Cardiovascular Research Center and Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
Physiol Res. 2011;60(3):381-402. doi: 10.33549/physiolres.932189. Epub 2011 May 27.
Essential hypertension is a multifactorial disorder which belongs to the main risk factors responsible for renal and cardiovascular complications. This review is focused on the experimental research of neural and vascular mechanisms involved in the high blood pressure control. The attention is paid to the abnormalities in the regulation of sympathetic nervous system activity and adrenoceptor alterations as well as the changes of membrane and intracellular processes in the vascular smooth muscle cells of spontaneously hypertensive rats. These abnormalities lead to increased vascular tone arising from altered regulation of calcium influx through L-VDCC channels, which has a crucial role for excitation-contraction coupling, as well as for so-called "calcium sensitization" mediated by the RhoA/Rho-kinase pathway. Regulation of both pathways is dependent on the complex interplay of various vasodilator and vasoconstrictor stimuli. Two major antagonistic players in the regulation of blood pressure, i.e. sympathetic nervous system (by stimulation of adrenoceptors coupled to stimulatory and inhibitory G proteins) and nitric oxide (by cGMP signaling pathway), elicit their actions via the control of calcium influx through L-VDCC. However, L-type calcium current can also be regulated by the changes in membrane potential elicited by the activation of potassium channels, the impaired function of which was detected in hypertensive animals. The dominant role of enhanced calcium influx in the pathogenesis of high blood pressure of genetically hypertensive animals is confirmed not only by therapeutic efficacy of calcium antagonists but especially by the absence of hypertension in animals in which L-type calcium current was diminished by pertussis toxin-induced inactivation of inhibitory G proteins. Although there is considerable information on the complex neural and vascular alterations in rats with established hypertension, the detailed description of their appearance during the induction of hypertension is still missing.
原发性高血压是一种多因素疾病,属于主要的危险因素,可导致肾脏和心血管并发症。本综述重点介绍了参与高血压控制的神经和血管机制的实验研究。特别关注了交感神经系统活性调节异常和肾上腺素能受体改变,以及自发性高血压大鼠血管平滑肌细胞的膜和细胞内过程变化。这些异常导致血管张力增加,源于通过 L-VDCC 通道的钙内流调节改变,这对兴奋-收缩偶联具有至关重要的作用,以及 RhoA/Rho-激酶通路介导的所谓“钙敏化”。两种途径的调节依赖于各种血管舒张和收缩刺激的复杂相互作用。调节血压的两个主要拮抗因子,即交感神经系统(通过与刺激和抑制 G 蛋白偶联的肾上腺素能受体的刺激)和一氧化氮(通过 cGMP 信号通路),通过控制通过 L-VDCC 的钙内流来发挥其作用。然而,L 型钙电流也可以通过激活钾通道引起的膜电位变化来调节,在高血压动物中检测到这些钾通道的功能受损。增强的钙内流在遗传性高血压动物高血压发病机制中的主导作用不仅通过钙拮抗剂的治疗效果得到证实,而且通过在 L 型钙电流通过百日咳毒素诱导的抑制性 G 蛋白失活而减少的动物中不存在高血压得到证实。尽管在已建立高血压的大鼠中已经有相当多的关于复杂的神经和血管改变的信息,但在高血压诱导期间它们的出现的详细描述仍然缺失。