[Application of Tianxiong Granules in treating hypertension from both heart and brain based on "heart-brain" axis].

Hypertension, a common risk factor for cardiovascular diseases, has aroused global concern. As breakthroughs have been achieved in the traditional Chinese medicine(TCM) and western medicine theories related to the heart and brain, top international journals such as Science pay increasing attention to the functional interaction between the heart and brain in modern medicine, known as the "heart-brain" axis, also referred to as the "cardiovascular-brain" circuit. The heart and brain interact and influence each other through the "heart-brain" axis. Increasing evidence suggests that the inflammation-regulated "heart-brain" axis plays a crucial role in the occurrence and development of hypertension, offering new insights for the treatment of cardiovascular diseases. In TCM, there is a connection between the heart and brain by the sharing of blood essence, interconnected blood vessels, and shared governance over the mind. Diseases of the heart and brain share common pathological and physiological foundations, similar risk factors, and TCM pathogeneses, which form the basis for simultaneous treatment of heart and brain diseases in TCM. The principle of simultaneous treatment of the heart and brain diseases aligns with the theory of "heart-brain" axis. Modern research has found that the heart and brain are the main target organs of hypertension. Long-term high blood pressure can easily cause structural changes, mainly characterized by left ventricular hypertrophy and dilation, leading to hypertensive heart disease. Hypertension can change the structure, blood supply, and function of the brain, being closely related to cerebral atherosclerosis, cerebral infarction, cerebral hemorrhage, cognitive dysfunction, dementia and other brain diseases. TCM treatment of hypertension has a long history. According to the pathogenesis(Yang hyperactivity and blood stasis) of hypertension, the team has developed the core treatment principle of subduing Yang and activating blood. Through extensive clinical exploration and experimental research, the team has developed an effective prescription called Tianxiong Granules. This prescription has shown definite efficacy in stabilizing blood pressure, ameliorating clinical symptoms, and reducing target organ damage. The protective effects of Tianxiong Granules on the heart and brain are reflected in aspects such as symptoms related to the heart and brain, pharmacological effects on ventricular hypertrophy, and brain protection. The preliminary research by the team found that Tianxiong Granules might treat hypertension by inhibiting sympathetic nerve excitation and renin-angiotensin-aldosterone system(RAAS) and targeting mitochondrial autophagy to regulate the activation of the NOD-like receptor family pyrin domain containing 3(NLRP3) inflammasome. The activation of the NLRP3 inflammasome mediates pyroptosis, which is a key mechanism of hypertension. Next, the team will construct the adeno-associated viruses with downregulated NLRP3 expression via adenoviral vectors and use viral tracing technology, left stellate ganglionectomy, and a cardiac denervation model to reveal the mechanism of Tianxiong Granules in regulating the heart-brain interaction in hypertensive rats, from both in vivo and in vitro perspectives. In summary, exploring clinical treatment strategies for hypertension from both heart and brain based on the "heart-brain" axis is likely to be a new direction for the development of drugs for hypertension and offers a new target and basis for intervention in hypertension.