Key result
The evolutionary shift to human bipedalism co-opted the low pressure cardiopulmonary reflex, leading to dysregulation that manifests as orthostatic intolerance and essential hypertension.
Why the study?
Cardiovascular adaptation to human bipedalism co-opted the low pressure cardiopulmonary reflex, leading to evolutionary faults such as orthostatic intolerance syndromes and essential hypertension.
Answers are grounded in this paper and cite their sources.
Understanding the evolutionary faults of the human cardiovascular response to bipedalism provides new insights into orthostatic intolerance and essential hypertension.
: In quadrupeds, the arterial baroreflex has dominance in the reflex homeostatic responses, which protect against haemorrhage. In humans, it is the low pressure cardiopulmonary reflex, which protects against the analogous cardiovascular challenge of gravity-dependent venous pooling with standing. To preserve orthostatic cardiovascular homeostasis with the emergence of bipedalism in humans the low pressure reflex, a minor, subsidiary reflex in quadripeds, was co-opted. Mirroring the imperfect skeletal evolution to bipedalism, this cardiovascular development has been problematic, with dysregulation manifesting as disabling orthostatic intolerance syndromes and, paradoxically, an orthostatic hypertensive response that appears to play a role in the development of essential hypertension in some people. Improved understanding of these evolutionary faults provides new options for postural and pharmacological treatments.
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Esler et al. (2019) conducted a review in Orthostatic intolerance syndromes and essential hypertension. Human bipedalism vs. Quadrupeds was evaluated. The evolutionary shift to human bipedalism co-opted the low pressure cardiopulmonary reflex, leading to dysregulation that manifests as orthostatic intolerance and essential hypertension.
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