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The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey

The present paper will provide an update on the role of sympathetic neural factors in the development and progression of essential hypertension by reviewing data collected in the past 10 years. This will be done by discussing the results of the published studies in which sympathetic neural function...

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Autor principal: Grassi, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643601/
https://www.ncbi.nlm.nih.gov/pubmed/34355740
http://dx.doi.org/10.1093/ajh/hpab124
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author Grassi, Guido
author_facet Grassi, Guido
author_sort Grassi, Guido
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description The present paper will provide an update on the role of sympathetic neural factors in the development and progression of essential hypertension by reviewing data collected in the past 10 years. This will be done by discussing the results of the published studies in which sympathetic neural function in essential hypertension and related disease has been investigated via sophisticated and highly sensitive techniques, such as microneurographic recording of sympathetic nerve traffic and regional norepinephrine spillover. First, the relevance of the pathophysiological background of the neurogenic alterations will be discussed. It will be then examined the behavior of the sympathetic neural function in specific clinical phenotypes, such as resistant hypertension, pseudoresistant hypertension, and hypertensive states displaying elevated resting heart values. This will be followed by a discussion of the main results of the meta-analytic studies examining the behavior of sympathetic nerve traffic in essential hypertension, obesity, metabolic syndrome, and chronic renal failure. The sympathetic effects of renal denervation and carotid baroreceptor stimulation as well as the possible involvement of sympathetic neural factors in the determination of the so-called “residual risk” of the treated hypertensive patients will be finally discussed.
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spelling pubmed-86436012021-12-06 The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey Grassi, Guido Am J Hypertens Review The present paper will provide an update on the role of sympathetic neural factors in the development and progression of essential hypertension by reviewing data collected in the past 10 years. This will be done by discussing the results of the published studies in which sympathetic neural function in essential hypertension and related disease has been investigated via sophisticated and highly sensitive techniques, such as microneurographic recording of sympathetic nerve traffic and regional norepinephrine spillover. First, the relevance of the pathophysiological background of the neurogenic alterations will be discussed. It will be then examined the behavior of the sympathetic neural function in specific clinical phenotypes, such as resistant hypertension, pseudoresistant hypertension, and hypertensive states displaying elevated resting heart values. This will be followed by a discussion of the main results of the meta-analytic studies examining the behavior of sympathetic nerve traffic in essential hypertension, obesity, metabolic syndrome, and chronic renal failure. The sympathetic effects of renal denervation and carotid baroreceptor stimulation as well as the possible involvement of sympathetic neural factors in the determination of the so-called “residual risk” of the treated hypertensive patients will be finally discussed. Oxford University Press 2021-08-06 /pmc/articles/PMC8643601/ /pubmed/34355740 http://dx.doi.org/10.1093/ajh/hpab124 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Grassi, Guido
The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey
title The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey
title_full The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey
title_fullStr The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey
title_full_unstemmed The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey
title_short The Sympathetic Nervous System in Hypertension: Roadmap Update of a Long Journey
title_sort sympathetic nervous system in hypertension: roadmap update of a long journey
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643601/
https://www.ncbi.nlm.nih.gov/pubmed/34355740
http://dx.doi.org/10.1093/ajh/hpab124
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