SIGNIFICANCE: Hypertension is a multifactorial disease ensuing from the continuous challenge imposed by several risk factors on the cardiovascular system. Classically known pathophysiological alterations associated with hypertension comprise neurogenic mechanisms dysregulating the autonomic nervous system, vascular dysfunction, excessive activation of the renin angiotensin system. During the last years, a considerable number of studies indicated that also immune activation and inflammation have an important role in the onset and maintenance of hypertension.
CRITICAL ISSUES: On these premises, it has been necessary reconsidering the pathophysiological mechanisms underlying hypertension development, taking into account the potential interactions established between classically known determinants of high blood pressure and the immune system. Recent Advances: Interestingly, central nervous system areas controlling cardiovascular functions are enriched of Angiotensin II receptors. Observations showing that these brain areas are crucial for mediating peripheral autonomic nervous system and immune responses, were suggestive of a critical role of neuroimmune interactions in hypertension. In fact, the autonomic nervous system, characterized by an intricate network of afferent and efferent fibers, represents an intermediate between the brain and peripheral responses essential for blood pressure regulation.
FUTURE DIRECTIONS: In this review we will summarize studies showing how specific brain areas can modulate immune responses involved in hypertension.