Researchers at the University of Virginia School of Medicine have identified a small population of nerve cells in the brainstem that helps maintain steady blood pressure throughout the day. The cells limit blood pressure swings as people move between activities like sleeping, waking, standing, and exercising.
Stephen Abbott, PhD, the lead investigator, found that loss of just a few hundred of these nerve cells leads to unstable blood pressure even when average readings remain normal. "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," Abbott said. "This shows that the system that keeps blood pressure steady from moment to moment is no longer working."
The same nerve cells have previously been found damaged or missing in people with multiple system atrophy, a rare neurological disorder related to Parkinson's disease, which often involves severe blood pressure regulation problems. The new findings raise the possibility that disruptions in these brain cells may contribute to unstable blood pressure in other medical conditions, including cases where standard measurements show normal average levels.
Abbott emphasized that treatment approaches may need to shift focus. "Our work emphasizes a new appreciation for how we think about blood pressure problems," he said. "It's not just about lowering the numbers - it's about keeping blood pressure stable from moment to moment."
The research team included George M.P.R. Souza, Harsha Thakkalapally, Faye E. Berry, Leah F. Wisniewski, Ulrich M. Atongazi, and Daniel S. Stornetta. The study was published in Circulation Research and funded by the National Institutes of Health through grant HL148004.