Corticolimbic regulation of cardiovascular responses to stress

•Stress and stress-related psychiatric illness greatly increase susceptibility to cardiovascular disease.•Corticolimbic nuclei are critical for stress appraisal and reactivity.•The organization and integration of corticolimbic circuits for generating cardiovascular stress responses are largely unknown.

Cardiovascular disease, a leading cause of death worldwide, is frequently initiated or exacerbated by stress. In fact, chronic stress exposure and heightened reactions to acute psychological stress are both associated with increased cardiovascular morbidity. This brief review focuses on the mechanisms by which corticolimbic nuclei, critical for stress appraisal and emotional reactivity, regulate heart rate and blood pressure responses to psychological stress. Both human and rodent data are examined with a major emphasis on basic studies investigating prefrontal cortex, amygdala, and hippocampus. A detailed literature review reveals substantial limitations in our understanding of this circuitry, as well as significant opportunities for future investigation that may ultimately reduce the burden of cardiovascular illness.