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Hypertension: a problem of organ blood flow supply–demand mismatch

This review introduces a new hypothesis that sympathetically mediated hypertensive diseases are caused, in the most part, by the activation of visceral afferent systems that are connected to neural circuits generating sympathetic activity. We consider how organ hypoperfusion and blood flow supply–de...

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Detalles Bibliográficos
Autores principales: Koeners, Maarten P, Lewis, Kirsty E, Ford, Anthony P, Paton, Julian FR
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Future Medicine Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926521/
https://www.ncbi.nlm.nih.gov/pubmed/27091483
http://dx.doi.org/10.2217/fca.16.5
Descripción
Sumario:This review introduces a new hypothesis that sympathetically mediated hypertensive diseases are caused, in the most part, by the activation of visceral afferent systems that are connected to neural circuits generating sympathetic activity. We consider how organ hypoperfusion and blood flow supply–demand mismatch might lead to both sensory hyper-reflexia and aberrant afferent tonicity. We discuss how this may drive sympatho-excitatory-positive feedback and extend across multiple organs initiating, or at least amplifying, sympathetic hyperactivity. The latter, in turn, compounds the challenge to sufficient organ blood flow through heightened vasoconstriction that both maintains and exacerbates hypertension.