A small population of nerve cells in the brainstem helps keep blood pressure steady as people move through ordinary activities — sleeping, waking, standing, exercising — and losing just a few hundred of those cells can cause dangerous swings even when a person's average reading looks completely normal, according to new research from the University of Virginia School of Medicine.
"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," said Stephen Abbott, the study's lead investigator. "This shows that the system that keeps blood pressure steady from moment to moment is no longer working." The findings, published in the journal Circulation Research, suggest doctors may need to pay closer attention to fluctuation, not just averages, since rapid or excessive blood pressure swings have been linked independently to heart disease, stroke and brain injury.
The same brainstem cells have previously been found damaged or missing in people with multiple system atrophy, a rare and fatal neurological disorder related to Parkinson's disease that often comes with severe blood pressure instability. Researchers say the discovery raises the possibility that disruptions to these cells could also play a role in unstable blood pressure linked to other, more common conditions — including cases where standard readings appear unremarkable. "Our work emphasizes a new appreciation for how we think about blood pressure problems," Abbott said. "It's not just about lowering the numbers — it's about keeping blood pressure stable from moment to moment."
The research, funded by the National Institutes of Health, is part of a broader push at UVA's newly established Paul and Diane Manning Institute of Biotechnology to move laboratory findings on complex diseases more quickly toward patient treatments.