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The Sympathetic Nervous System Alterations in Human Hypertension

Circulation research, 2015-03, Vol.116 (6), p.976-990 [Peer Reviewed Journal]

2015 American Heart Association, Inc. ;ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.116.303604 ;PMID: 25767284

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Title:
The Sympathetic Nervous System Alterations in Human Hypertension
Author: Grassi, Guido ; Mark, Allyn ; Esler, Murray
Subjects: Animals ; Antihypertensive Agents - pharmacology ; Antihypertensive Agents - therapeutic use ; Clinical Trials as Topic ; Diagnostic Techniques, Cardiovascular ; Forecasting ; Heart Rate - physiology ; Humans ; Hyperinsulinism - physiopathology ; Hypertension - drug therapy ; Hypertension - etiology ; Hypertension - physiopathology ; Hypertension - therapy ; Hypertension, Renal - physiopathology ; Hypertension, Renal - surgery ; Insulin Resistance - physiology ; Kidney - innervation ; Kidney Diseases - complications ; Kidney Diseases - physiopathology ; Leptin - deficiency ; Leptin - physiology ; Melanocortins - physiology ; Metabolic Syndrome - complications ; Metabolic Syndrome - physiopathology ; Multicenter Studies as Topic ; Neuroimaging ; Norepinephrine - blood ; Obesity - complications ; Obesity - physiopathology ; Sympathectomy - methods ; Sympathetic Fibers, Postganglionic - physiology ; Sympathetic Nervous System - physiopathology ; Vasoconstriction - physiology
Is Part Of: Circulation research, 2015-03, Vol.116 (6), p.976-990
Description: Several articles have dealt with the importance and mechanisms of the sympathetic nervous system alterations in experimental animal models of hypertension. This review addresses the role of the sympathetic nervous system in the pathophysiology and therapy of human hypertension. We first discuss the strengths and limitations of various techniques for assessing the sympathetic nervous system in humans, with a focus on heart rate, plasma norepinephrine, microneurographic recording of sympathetic nerve traffic, and measurements of radiolabeled norepinephrine spillover. We then examine the evidence supporting the importance of neuroadrenergic factors as promoters and amplifiers of human hypertension. We expand on the role of the sympathetic nervous system in 2 increasingly common forms of secondary hypertension, namely hypertension associated with obesity and with renal disease. With this background, we examine interventions of sympathetic deactivation as a mode of antihypertensive treatment. Particular emphasis is given to the background and results of recent therapeutic approaches based on carotid baroreceptor stimulation and radiofrequency ablation of the renal nerves.
Publisher: United States: American Heart Association, Inc
Language: English
Identifier: ISSN: 0009-7330
EISSN: 1524-4571
DOI: 10.1161/CIRCRESAHA.116.303604
PMID: 25767284
Source: GFMER Free Medical Journals
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The Sympathetic Nervous System Alterations in Human Hypertension

2015 American Heart Association, Inc. ;ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.116.303604 ;PMID: 25767284

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