The defense reaction - a common denominator of coronary risk and blood-pressure in neurogenic hypertension
Abstract
In addition to high blood pressure, patients with hypertension often have insulin resistance, dyslipidemia and increased sympathetic tone. An increased sympathetic tone can negatively affect glucose utilization through three distinct mechanisms; a direct beta-adrenoreceptor-mediated insulin resistance, through conversion to more insulin resistant fast twitch fibers and through alpha-adrenergic vasoconstriction which may decrease the delivery of insulin and glucose to the skeletal muscle cells. The insulin resistance in turn may be responsible for the observed dyslipidemia in hypertension. The sympathetic overactivity in hypertension reflects a chronic activation of defense/vigilance reaction. The increase of cardiac output, blood pressure and insulin resistance in the course of the defense reaction are viewed as an appropriate preparatory response to facilitate muscular exercise (through higher cardiac output and increased pressure) and preserve (through insulin resistance) the optimal supply of glucose to the brain. The defense reaction may have been useful in evolution and may have offered survival advantage. In modern times with prolonged life expectancy the previously useful response (in evolutionary terms) contributes to a faster and deleterious wear and tear of the cardiovascular system.
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Julius (1995) argued that autonomic imbalance as indexed by chronic low HRV in overweight and related conditions such as diabetes was due to chronic 'hypervigilance' or 'defense' responses.
“Julius (1995) argued before that autonomic imbalance as indexed by chronic low HRV in overweight and related conditions such as diabetes was due to chronic 'hypervigilance' or 'defense' responses.”
From Exposed to events that never happen: generalized unsafety, the default stress response, and prolonged autonomic activity (2017) · cites this paper as Julius (1995)
Julius did not generalize his explanation to other 'compromised body' conditions and did not interpret those responses in terms of default stress responses caused by GU.
“However, he did not generalize this to other 'compromised body' conditions, and did not interpret those responses in terms of default stress responses caused by GU.”
From Exposed to events that never happen: generalized unsafety, the default stress response, and prolonged autonomic activity (2017) · cites this paper as Julius (1995)
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Stress and Health: A Review of Psychobiological Processes
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- Authors
- Julius, S.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Julius, Stevo
- Venue
- Clinical and Experimental Hypertension
- Publisher
- Informa UK Limited
- Published
- 1995-01
- Volume
- 17
- Issue
- 1-2
- Pages
- 375-386
- ISSN
- 0148-3927 (ISSN-L)
- 1064-1963
- 1525-6006
- OpenAlex
- W2043939337
- Cited by
- 37
- References
- 40
- Citations by year
- 2023: 2 · 2022: 1 · 2021: 1 · 2020: 1 · 2018: 2 · 2017: 2 · 2016: 2
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical and Experimental Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r37hl037464-10)
- National Heart, Lung, and Blood Institute (HL37464/-SI)
- National Center for Research Resources (5-MO1-RR-0042, M01RR000042)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- neurogenic hypertension, defense response, sympathetic nervous system, insulin resistance, dyslipidemia, coronary heart disease risk, blood pressure, cardiac output, beta-adrenergic receptors, alpha-adrenergic vasoconstriction, adaptive evolution
- MeSH terms
- Arousal, Arteriosclerosis, Blood Pressure, Cardiovascular Diseases, Cardiovascular System, Defense Mechanisms, Humans, Hypertension, Risk Factors, Sympathetic Nervous System, Vasoconstriction
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