Systems in the brain control blood pressure by maintaining life-sustaining, resting (tonic) levels and adjusting blood pressure in association with changes in regional blood flow appropriately coupled to behavior or environmental stimulation. Tonic levels of blood pressure are mediated by neurons in the medulla oblongata. The critical neurons appear to correspond to the epinephrine-containing cells of the so-called C1 group located in the rostral ventral lateral medulla. These also mediate baroreceptor reflex responses. Behaviorally coupled changes in blood pressure are often highly stereotyped and vary depending on the behavior being performed in both animals and humans. These reactive circulatory adjustments are largely mediated by forebrain regions working in concert with the medullary centers. Some of the largest increases in blood pressure occur in response to aversive emotional arousal. In hypertensive animals and humans, such changes, which are normally buffered by reflex mechanisms in the brainstem, are exaggerated. In the rat, the neural pathway mediating the coupling, through aversive emotional conditioning, of blood pressure responses to acoustic stimuli involves the transmission of sensory signals through the primary auditory projection system to the medial geniculate body, where the input is then relayed subcortically to the amygdala. The amygdala, presumably by way of connections with the hypothalamus, and from there to the brainstem or spinal cord, controls the learned emotional response. These findings, which implicate a largely unrecognized sensory relay to the amygdala in emotional learning, represent the first demonstration of a direct link between primary sensory system and autonomic control regions in the mammalian brain.