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Maintenance of brain function depends on a constant blood supply. Deficits in cerebral blood flow are linked to cognitive decline, and they have detrimental effects on the outcome of ischemia. Hypertension causes alterations in cerebral artery structure and function that can impair blood flow, particularly during an ischemic insult or during periods of low arterial pressure. This review will focus on the historical discoveries, novel developments, and knowledge gaps in 1) hypertensive cerebral artery remodeling, 2) vascular function with emphasis on myogenic reactivity and endothelium-dependent dilation, and 3) blood-brain barrier function. Hypertensive artery remodeling results in reduction in the lumen diameter and an increase in the wall-to-lumen ratio in most cerebral arteries; this is linked to reduced blood flow postischemia and increased ischemic damage. Many factors that are increased in hypertension stimulate remodeling; these include the renin-angiotensin-aldosterone system and reactive oxygen species levels. Endothelial function, vital for endothelium-mediated dilation and regulation of myogenic reactivity, is impaired in hypertension. This is a consequence of alterations in vasodilator mechanisms involving nitric oxide, epoxyeicosatrienoic acids, and ion channels, including calcium-activated potassium channels and transient receptor potential vanilloid channel 4. Hypertension causes blood-brain barrier breakdown by mechanisms involving inflammation, oxidative stress, and vasoactive circulating molecules. This exposes neurons to cytotoxic molecules, leading to neuronal loss, cognitive decline, and impaired recovery from ischemia. As the population ages and the incidence of hypertension, stroke, and dementia increases, it is imperative that we gain a better understanding of the control of cerebral artery function in health and disease.

Abstract-We previously reported increased aortic reactive oxygen species (ROS) production in mineralocorticoid (deoxycorticosterone acetate [DOCA]-salt) hypertensive rats. In the present study, we tested the hypothesis that NADH/NADPH oxidase is responsible for increased ROS production, namely superoxide (O 2 Ϫ ), in aorta from the DOCA-salt rat. Treatment of aortic rings from DOCA-salt rats with the NO synthase inhibitor N-nitro-L-arginine and the xanthine oxidase inhibitor allopurinol did not significantly change O 2 Ϫ production. Furthermore, de-endothelialization of aorta from DOCA-salt rats did not affect O 2 Ϫ production compared with that of sham-operated rats. Thus, xanthine oxidase and uncoupled endothelial NO synthase were not responsible for increased O 2 Ϫ production in the DOCA-salt rats. In contrast, treatment with the NADPH oxidase inhibitor apocynin significantly decreased O 2 Ϫ production in aortic rings from DOCA-salt rats compared with sham-operated rats. Moreover, long-term administration of apocynin (in drinking water, 1.5 mmol/L, 28 days) to DOCA-salt rats significantly decreased systolic blood pressure compared with that of rats treated with DOCA-salt alone. Furthermore, O 2 Ϫ production in aortic rings from DOCA-salt rats treated with apocynin for 28 days was reduced compared with that of untreated DOCA-salt rats. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis demonstrated that DOCA-salt rats have significantly greater mRNA levels of the NADPH oxidase subunit p22phox than do sham-operated rats. These findings suggest that NADPH oxidase is increased and is responsible for increased O 2 Ϫ production and possibly contributes to increased blood pressure in the DOCA-salt hypertensive rat. Key Words: deoxycorticosterone acetate Ⅲ NADH/NADPH Ⅲ mineralocorticoids Ⅲ hypertension, mineralocorticoid H ypertension, atherosclerosis, and mechanical injury exert common pathological effects on the vessel wall, such as vascular smooth muscle cell (VSMC) proliferation, monocyte/macrophage infiltration, endothelial dysfunction, and increased connective tissue deposition. 1 In addition, these vascular diseases have been shown to be associated with oxidative stress, and there is good evidence implicating angiotensin II in the oxidative stress associated with hypertension. 2,3 However, we 4 and others 5 have reported increased oxidative stress in mineralocorticoid (deoxycorticosterone acetate [DOCA]) hypertension, which is characterized by low angiotensin II levels. We also found that oxidative stress causes increased transcription of genes responsible for the early inflammatory response in the DOCA-salt hypertensive rat. 4 Moreover, a potentially significant consequence of oxidative stress is vascular smooth muscle cell proliferation 6 and NO inactivation, 7 which could play an important role in the vascular changes and causes of hypertension. However, the source of the oxidative (reactive oxygen species [ROS]) stress is not known. Early studies have identified endothelial xanthine oxidase ...

Objective-Obesity and hypertension are comorbid in epidemic proportion, yet their biological connection is largely a mystery. The peptide chemerin is a candidate for connecting fat deposits around the blood vessel (perivascular adipose tissue) to arterial contraction. We presently tested the hypothesis that chemerin is expressed in perivascular adipose tissue and is vasoactive, supporting the existence of a chemerin axis in the vasculature. Approach and Results-Real-time polymerase chain reaction, immunohistochemistry, and Western analyses supported the synthesis and expression of chemerin in perivascular adipose tissue, whereas the primary chemerin receptor ChemR23 was expressed both in the tunica media and endothelial layer. The ChemR23 agonist chemerin-9 caused receptor, concentration-dependent contraction in the isolated rat thoracic aorta, superior mesenteric artery, and mesenteric resistance artery, and contraction was significantly amplified (more than 100%) when nitric oxide synthase was inhibited and the endothelial cell mechanically removed or tone was placed on the arteries. The novel ChemR23 antagonist CCX832 inhibited phenylephrine-induced and prostaglandin F2α-induced contraction (+perivascular adipose tissue), suggesting that endogenous chemerin contributes to contraction. Arteries from animals with dysfunctional endothelium (obese or hypertensive) demonstrated a pronounced contraction to chemerin-9. Finally, mesenteric arteries from obese humans demonstrate amplified contraction to chemerin-9. Conclusions-These Watts et al Chemerin as a Vasoconstrictor 1321also play a role in obesity. Additionally, chemerin regulates adipocyte differentiation [18][19][20] and production of several proinflammatory cytokines. We hypothesized that a chemerin axis exists in blood vessels. We propose that chemerin and the primary receptor for chemerin, ChemR23, are present and mediate contraction in the vasculature. Materials and MethodsMaterials and Methods are available in the online-only Supplement. Results Arterial Chemerin AxisIsolated rat arteries express chemerin protein in the PVAT ( Figure 1A). Real-time polymerase chain reaction supports the expression of chemerin (RARRES2) mRNA in the rat thoracic aortic PVAT (whole PVAT; threshold cycle [C T ] =22.78±0.35; β2-microglobulin as control = 19.32±0.27; n=6). Chemerin signal does not wholly derive from resident mast cells because there was negligible CD68 staining in PVAT ( Figure 1B, + control below), and staining for chemerin was, in many places, not punctate. Positive staining was observed within the cytoplasm of the fat cell, outside the rounded lipid droplet. The predominant receptor for chemerin, ChemR23, is expressed in the tunica media and endothelial cell layer ( Figure 1C) and is observed as 3 dominant bands in homogenates (−PVAT) of the thoracic aorta and superior mesenteric artery cleaned of PVAT ( Figure 1D and 1E). Two bands (at arrows) are consistent with that observed in a JAR (choriocarcinoma) positive control and were 42 kDa (expected size for...