Investigation of the postulated central hypotensive actions of clonidine, methyldopa and P-adrenoreceptor blocking drugs has prompted intensive research into the neurophysiological basis of central cardiovascular control. Species differences and the general lack of specificity of the pharmacological tools available complicate such investigations. Although many studies implicate noradrenaline as a transmitter in central cardiovascular control, there have been conflicting reports regarding the role(s) of this putative neurotransmitter. The postulated roles of brain amines in experimental hypertension have been reviewed by Chalmers (1975).In this review evidence for the noradrenergic control of blood pressure and heart rate in the spinal cord, at the level of the medulla and from within the hypothalamus is discussed in the light of recent attempts to characterise central adrenoreceptors.Early electrical brain stimulation studies showed the most important areas able to modify cardiovascular function are located in the brain stem and hypothalamus (reviews by Korner, 1971 ;Smith, 1974). The area of the nucleus tractus solitarius in the medulla was found to be the site of one of the primary relays of the baroreceptor or carotid sinus afferent fibres (Crill & Reis, 1968). Baroreceptor activity has been found to project via polysynaptic pathways as far as the hypothalamus; furthermore, electrical stimulation of the hypothalamus has been shown to modify baroreceptor reflexes.The histochemical fluorescence technique developed by Falck et al.(1 962) and the more sensitive glyoxylic acid fluorescence method used by Lindvall & Bjorklund (1974) subsequently revealed a dense noradrenergic innervation of nuclei within the brain stem, spinal cord and hypothalamus. These nuclei include the intermedio-lateral nucleus of the spinal cord, the nucleus tractus solitarius, dorsal vagal nucleus, nucleus reticularis lateralis and locus coeruleus of the medulla, and nuclei of both the posterior and anterior hypothalamus. From the beginning of this decade therefore, it has been general opinion that the distribution of noradrenaline containing nerve endings in the mid brain and hind brain strongly suggests a transmitter role of noradrenaline in modulating central cardiovascular control (Bolme, Fuxe & Lidbrink, 1972).
Control of blood pressure at the spinal levelA high density of noradrenalinecontaining neurones has been demonstrated in the intermedio-lateral columns where they appear to make intimate synaptic contact with sympathetic preganglionic neurones. a-Adrenoreceptors and glycine receptors appear to mediate inhibition of thoracico-lumbar preganglionic sympathetic neurones (Haeusler, 1976) while padrenoreceptors at this level may facilitate tachycardia and hypertension (Bhargava et al., 1978).