A newly identified brainstem mechanism linking breathing and blood pressure may help explain certain forms of hypertension and point toward new treatment strategies targeting oxygen-sensing cells in the neck.
Scientists have identified a region of the brain that may contribute to high blood pressure.
The lateral parafacial region is located in the brainstem, the most ancient part of the brain, responsible for automatic processes such as breathing, digestion, and heart rate.
“The lateral parafacial region is recruited into action, causing us to exhale during a laugh, exercise, or coughing,” says lead researcher Professor Julian Paton, director of Manaaki Manawa, Centre for Heart Research at Waipapa Taumata Rau, University of Auckland.
“These exhalations are what we call ‘forced’ and are driven by our powerful abdominal muscles. In contrast, a normal exhalation does not need these muscles to contract; it happens because the lungs are elastic.”
A Brainstem Region Linked to Blood Pressure
Researchers found that this same brain area also communicates with nerves that constrict blood vessels. When these nerves tighten blood vessels, blood pressure rises.
“We’ve unearthed a new region of the brain that is causing high blood pressure. Yes, the brain is to blame for hypertension!” says Paton.
“We discovered that, in conditions of high blood pressure, the lateral parafacial region is activated and, when our team inactivated this region, blood pressure fell to normal levels.”
The findings suggest that certain breathing patterns, particularly those involving strong abdominal muscle contractions, may help drive increases in blood pressure. Identifying this type of abdominal breathing in people with hypertension could help doctors determine the underlying cause and guide treatment.
The study was recently published in the specialist journal Circulation Research.
‘Can we target this brainstem region?’
Researchers then explored whether this brainstem region could be influenced with medication.
“Targeting the brain with drugs is tricky because they act on the entire brain and not a selected region such as the parafacial nucleus,” says Paton.
The team then made an important discovery. Signals that activate this brain region do not originate only within the brain. They also come from the carotid bodies, small clusters of cells in the neck near the carotid artery that detect oxygen levels in the blood.
Because these sensors are outside the brain, they can potentially be targeted with medication more safely.
“Our goal is to target the carotid bodies, and we are importing a new drug that is being repurposed by us to quench carotid body activity and inactivate ‘remotely’ the lateral parafacial region safely, i.e., without needing to use a drug that penetrates the brain.”
The discovery could lead to new treatment approaches for high blood pressure. It may be particularly relevant for people with sleep apnea, since carotid bodies are known to become active in these patients when breathing stops during sleep.
Reference: “Lateral Parafacial Neurons Evoked Expiratory Oscillations Driving Neurogenic Hypertension” by Karolyne S. Magalhães, Renato W. Martins Sá, Nathalia Salim, Thaís Marques da Silva, Benedito H. Machado, Julian F.R. Paton and Davi J.A. Moraes, 17 December 2025, Circulation Research.
DOI: 10.1161/CIRCRESAHA.125.326674
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