| Harvey Cushing and the regulation of blood pressure in giraffe, rat and man: introducing 'Cushing's mechanism'. | |
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MedLine Citation:
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PMID: 18820004 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The fundamental mechanism that underlies essential hypertension is a high total peripheral resistance. We review here possible origins of high total peripheral resistance in physiologically hypertensive giraffes, spontaneously hypertensive rats and humans with essential hypertension. We propose that a common link could be reduced brainstem perfusion, as first suggested by Cushing in 1901. Any tendency towards reduction of cerebral blood flow to the cardiovascular control centres in rest and sleep will be prevented by activation of a response arising in the brainstem. The response will proportionately increase systemic blood pressure and return cerebral blood flow to a new homeostatic level. New evidence we review here supports this idea and leads us to suggest that central regulation of blood pressure has two components: the classic Cushing's response, which is a terminal event, and a Cushing's mechanism, which is a physiological mechanism for long-term control of mean arterial pressure. In giraffes, Cushing's mechanism is activated by increasing neck length during growth and subsequent gravitational hypotension that stimulates a rise in basal arterial blood pressure. In man and rats, the mechanism is activated by narrowing of the arteries supplying the brainstem. If we are correct, future successful treatment of essential hypertension in man will include methods of reducing cerebral arterial resistance. |
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Authors:
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J F R Paton; C J Dickinson; G Mitchell |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review Date: 2008-09-26 |
Journal Detail:
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Title: Experimental physiology Volume: 94 ISSN: 1469-445X ISO Abbreviation: Exp. Physiol. Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-06 Completed Date: 2009-04-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9002940 Medline TA: Exp Physiol Country: England |
Other Details:
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Languages: eng Pagination: 11-7 Citation Subset: IM |
Affiliation:
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Department of Physiology & Pharmacology, Bristol Heart Institute, School of Medical Sciences, University of Bristol, Bristol BS8 1TD, UK. julian.f.r.paton@bristol.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Pressure / physiology* Brain Stem / physiology* Cerebrovascular Circulation / physiology* Homeostasis / physiology Humans Hypertension / physiopathology Neck / anatomy & histology Rats Ruminants Species Specificity Vascular Resistance / physiology |
| Grant Support | |
ID/Acronym/Agency:
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//British Heart Foundation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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