Unveiling the heart’s silent whisperer: study of stress and the brain–heart connection in Europe

Graphical AbstractOpen in new tabDownload slideDysregulation of the prefrontal cortex and amygdala relationship by chronic stress has direct effects on the cardiovascular system, via the hypothalamic-pituitary-adrenal (HPA) axis. These effects, which include include vasoconstriction, increased vascular resistance, increased heart rate, and decreased heart rate variability (HRV), are potentiated by SNS hyperactivation, which promotes the release of norepinephrine into the systemic circulation. Activation of the HPA axis results in the release of cortisol from the adrenal cortex, which promotes cardiometabolic disease in the form of hypertension, increased adiposity, and insulin resistance. Subsequent vascular remodelling can lead to hypoperfusion, and potentially further dysregulation of the relationship between the prefrontal cortex and amygdala.