Site updated at Thursday, 03 January 2019

Health - Severe Hypertension

The Role of the Endocrine System in Blood Pressure

Saturday, Dec 22 2007


Blood pressure is also affected by various hormones of the neuroendocrine system, particularly norepinephrine (noradrenalin), epinephrine (adrenalin), and cortisol (see dashed lines in Figure 1.2). Stimulation of the sympathetic nervous system leads to the release of the catecholamines, epinephrine and norepinephrine, from the adrenal medulla and of the corticosteroid, cortisol, from the adrenal cortex.

Unlike the immediate action of the autonomic nervous system described above, the neuroendocrine response is a little slower. In contrast to the direct neural pathways of the autonomic nervous system to the various elements of the circulatory system, the neuroendocrine response relies on the circulatory system itself to transport hormonal secretions to various target organs and receptors.

Norepinephrine generally results in increased vasoconstriction while epinephrine results in the dilation of vessels adjacent to muscle cells. Both epinephrine and norepinephrine increase heart rate. During a bout of exercise, epinephrine exerts a significant vasodilatory effect on the blood vessels associated with the skeletal muscles. Corticosteroids, including cortisol, also have an effect on blood pressure. Without the presence of cortisol, the influence of epinephrine and norepinephrine upon vascular responses is minimized (Drew and Leach, 1971). Therefore, cortisol facilitates the action of the catecholamines.

Major physiological systems involved in the regulation of blood pressure (dotted arrows represent local blood cell autoregulation; solid arrows represent neural influences; dashed arrows represent neuroendocrine influences; SNS sympathetic nervous system).

Renin, a humoral substance produced in the kidneys, also influences blood flow by converting angiotensin to angiotensin II, another vasoconstrictive hormone. Angiotensin II then signals the adrenal cortex to secrete aldosterone, which causes the body to retain sodium.

Sodium retention causes the body to retain fluid, resulting in an increase in blood volume and thus increased blood pressure. There are numerous other hormones that affect blood pressure, operating as either vasoconstrictive or vasodilatory agents. The reader is referred to a full description of them in Kaplan (2002).

Larkin, K. T., and Zayfert, C.
Published with assistance from the foundation established in memory of Amasa Stone Mather of the Class of 1907, Yale College.

  • Abel, J. A., and Larkin, K. T. (1991). Assessment of cardiovascular reactivity across laboratory and natural settings. Journal of Psychosomatic Research, 35, 365 - 373.
  • Achmon, J., Granek, M., Golomb, M., and Hart, J. (1989). Behavioral treatment of essential hypertension: A comparison between cognitive therapy and biofeedback of heart rate. Psychosomatic Medicine, 51, 152 - 164.
  • Agras, W. S., Horne, M., and Taylor, C. B. (1982). Expectation and the blood-pressure-lowering effects of relaxation. Psychosomatic Medicine, 44, 389 - 395.
  • Agras, W. S., Taylor, C. B., Kraemer, H. C., Southam, M. A., and Schneider, J. A. (1987). Relaxation training for essential hypertension at the worksite: II. The poorly controlled hypertensive. Psychosomatic Medicine, 49, 264 - 273.
  • Aivazyan, T. A., Zaitsev, V. P., Khramelashvili, V. V., Golenov, E. V., and Kichkin, V. I. (1988). Psychophysiological interrelations and reactivity characteristics in hypertensives. Health Psychology, 7, 137 - 144.
  • al'Absi, M., and Wittmers, L. E. (2003). Enhanced adrenocortical responses to stress in hypertension-prone men and women. Annals of Behavioral Medicine, 25, 52 - 33.
  • Albright, C. L., Winkleby, M. A., Ragland, D. R., Fisher, J., and Syme, S. L. (1992). Job strain and prevalence of hypertension in a biracial population of urban bus drivers. American Journal of Public Health, 82, 984 - 989.
  • Davidyan, A. (1989). Emotional factors in essential hypertension. Psychosomatic Medicine, 55, 505 - 517.
  • Alfredsson, L., Davidyan, A., Fransson, E., de Faire, U., Hallqvist, J., Knutsson, A., et al. (2002). Job strain and major risk factors for coronary heart disease among employed males and females in a Swedish study on work, lipids, and fibrinogen. Scandinavian Journal of Work, Environment and Health, 28, 238 - 248.
Revision date: March 4, 2010
Last revised: by Dr. Daniel K. Polonsky,, D.M.D.

Provided by Armina Hypertension Association

Post a comment [ + Comment here + ]

There are no comments for this entry yet. [ + Comment here + ]

Your details

* Required field

Please enter the word you see in the image below:

Comments are moderated by our editors, so there may be a delay between submission and publication of your comment. Offensive or abusive comments will not be published.