Seth W. Holwerda, PhD
Kansas Neural Cardiovascular Control Laboratory Director
Department of Anesthesiology
The overarching theme of the laboratory is understanding mechanisms contributing to the development of hypertension and cardiovascular disease and innovative approaches to intervene. The focus is on the autonomic nervous system and vascular function.
The first is focused on chronic pain-related hypertension. Chronic pain, such as low back pain, is the greatest contributor to disability worldwide and is associated with impaired autonomic function. We are performing studies to further understand the vital interactions between pain and autonomic regulatory systems that may be working in a feed-forward fashion to promote chronic pain and hypertension in a vicious cycle. Studies include patients receiving epidural spinal cord stimulator devices, which block pain signals from reaching the brain. The hypothesis is that epidural spinal cord stimulation may be favorably influencing the autonomic nervous system in addition to reducing chronic pain symptoms. The goal is to determine the extent to which hypertension and impaired autonomic function predict improvements in chronic pain symptoms following the implant of a spinal cord stimulator device. The secondary goal is the determine the extent to which improvements in chronic pain symptoms reduce blood pressure. Results may improve the ability to predict which patients will respond most favorably to pain therapy and reduce the prevalence of hypertension in patients with chronic pain.
The second research track is focused on obesity-related hypertension. Nearly 75% of cases of hypertension can be attributed to obesity. Hallmarks of obesity-related hypertension are oxidative stress, chronic inflammation, and vascular dysfunction. To further understanding the vascular mechanisms underlying the development of hypertension in obesity, we use an innovative method to assess the influence of sympathetic nerve activity, which plays a significant role in hypertension, on vascular function with high resolution. We are launching studies that will examine the influence of elevated blood glucose and lipids on vascular sensitivity to sympathetic nerve activity and the role of oxidative stress that is created by elevated glucose and lipids. Sympathetic nerve activity also plays a role in inflammation, and we are performing studies to examine the extent to which anti-hypertensive drugs that block sympathetic nerve activity reduce the inflammatory profile often observed in obesity and insulin resistance. The urgency to mitigate inflammation in obesity has recently been accelerated by the increased risk of poor outcomes following infection by SARS-CoV-2.
The University of Kansas Medical Center (KUMC) has an incredible list of talented investigators and is a rich environment for collaboration. Studies performed in our lab are based on collaboration and leveraging the exceptional talent of investigators at KUMC to move our field of research forward.