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Editorial
. 2012 Mar;59(3):548-9.
doi: 10.1161/HYPERTENSIONAHA.111.187278. Epub 2012 Feb 6.

New therapies for postural hypotension

Michael G Ziegler, Milos Milic
Editorial

New therapies for postural hypotension

Michael G Ziegler et al. Hypertension. 2012 Mar.
No abstract available

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Figures

Figure
Figure
Increasing blood pressure stretches the blood vessel wall which initiates nerve firing from the baroreceptor. Decreased baroreceptor nerve firing allows brainstem activation of the sympathetic nervous system, leading to firing of pre and post ganglionic sympathetic nerves. The post ganglionic nerves release norepinephrine (NE) and adenosine triphosphate (ATP). The NE activates α1 and α2 receptors until the NE is transported out of the synapse by norepinephrine transporter (NET). Yohimbine blocks α2 receptors and aotomoxetine blocks NET, increasing intrasynaptic NE levels. Adenosine from the nerve and from ATP activates presynaptic receptors to inhibit NE release and vasodilate. Caffeine blocks both adenosine actions. Stimulation of α1 receptors leads to contraction of vascular smooth muscle; Blood flow and α2 induced nitric oxide (NO) release relaxes vascular smooth muscle. DA, dopamine. CNS, central nervous system. IX, X, glossopharingeal and vagus nerves. A1, A2A adenosine receptors. eNOS, endothelial nitric oxide synthase.
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