Sympathetic Nervous System and Hypertension
TLDR
This review will encompass recent publications dealing with the sympathetic nervous system and hypertension, focusing on those recently published in Hypertension.Abstract:
With the development and implementation of device-based therapeutic interventions to decrease renal and systemic nerve activity in patients with resistant hypertension, there has been an increase in research dealing with the role of the sympathetic nervous system in hypertension. These interventions have produced substantial decreases in blood pressure in patients wherein pharmacological treatments, including agents which inhibit the effects of the renin–angiotensin–aldosterone system, have failed serves to confirm and reassert the essential role of the sympathetic nervous system in hypertension. This review will encompass recent publications dealing with the sympathetic nervous system and hypertension, focusing on those recently published in Hypertension .
### Obesity-Related Hypertension
Although there has been a debate as to whether sympathetic activation is a cause or consequence of obesity, the studies noted below support the view that it is the obesity that leads to sympathetic activation. The importance of this sympathetic activation for the development of the hypertension is supported by the finding that renal denervation prevents the development of obesity hypertension in the dog.
Studies have now focused on the developmental phase of obesity hypertension regarding the renal sympathoexcitation. In rabbits fed high-fat diets, body weight, plasma insulin and leptin concentrations, mean arterial pressure, heart rate, and renal sympathetic nerve activity were all increased after 1 week.1 Mean arterial pressure and body weight continued to increase over 3 weeks of high-fat diet, whereas heart rate and renal sympathetic nerve activity did not change further. Arterial baroreflex control of renal sympathetic nerve activity was attenuated from the first week of the high-fat diet. Excitatory responses to air jet stress diminished over 3 weeks of high-fat diet. Resumption of normal diet normalized glucose, insulin, leptin, and heart rate, but body weight, visceral fat content, mean arterial pressure, and renal sympathetic nerve activity remained elevated. Increased renal sympathetic nerve activity …read more
Citations
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Journal ArticleDOI
Selective Proximal Renal Denervation Guided by Autonomic Responses Evoked via High-Frequency Stimulation in a Preclinical Canine Model
Jiayi Lu,Zhenglong Wang,Tingquan Zhou,Shaojie Chen,Weijie Chen,Huaan Du,Zhen Tan,Hanxuan Yang,Xinyu Hu,Chang Liu,Zhiyu Ling,Zengzhang Liu,Bernhard Zrenner,Kamsang Woo,Yuehui Yin +14 more
TL;DR: Renal afferent nerves can be mapped safely, and HFS-guided targeted proximal RDN can achieve apparent BP reduction and sympathetic inhibition.
Patent
Renal Nerve Stimulation Method for Treatment of Patients
Howard R. Levin,Mark Gelfand +1 more
TL;DR: A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve is described in this article, where the goal is to reduce the sympathetic activity of renal nerve.
Journal ArticleDOI
Anatomy and Physiology of the Autonomic Nervous System
TL;DR: A detailed understanding of the neural network presented above may explain the role of the vestibular system on the homeostasis more extensively.
Patent
Mediguide-enabled renal denervation system for ensuring wall contact and mapping lesion locations
TL;DR: An ablation catheter includes an elongated body having a proximal end and a distal end as mentioned in this paper, where at least one ablation element is disposed on the body and configured to ablate renal tissue to control hypertension.
Journal ArticleDOI
Hypothalamic and inflammatory basis of hypertension.
Sinan Khor,Dongsheng Cai +1 more
TL;DR: The neural mechanisms of hypertension with a focus on neuroendocrine and neurotransmitter involvement are summarized, highlighting recent findings that suggest that hypothalamic inflammation disrupts key signalling pathways to affect the central control of blood pressure, and suggesting future development of interventional strategies that exploit recent findings.
References
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Journal ArticleDOI
Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): A randomised controlled trial
Murray D. Esler,Henry Krum,Paul A. Sobotka,Markus P. Schlaich,Roland E. Schmieder,Michael Böhm,Felix Mahfoud,Horst Sievert,Nina Wunderlich,Lars Christian Rump,Oliver Vonend,Michael Uder,Mel Lobo,Mark J. Caulfield,Andrejs Erglis,Michel Azizi,Marc Sapoval,S. Thambar,Alexandre Persu,Jean Renkin,Heribert Schunkert,Joachim Weil,Uta C. Hoppe,Tony Walton,Dierk Scheinert,Thomas Binder,Andrzej Januszewicz,Adam Witkowski,Luis M. Ruilope,Robert Whitbourn,Heike Bruck,Mark Downes,Thomas F. Lüscher,Alan G. Jardine,Mark Webster,Thomas Zeller,Jerzy Sadowski,Krzysztof Bartus,Craig A. Straley,Neil C. Barman,David P. Lee,Ronald M. Witteles,Vivek Bhalla,Joseph M. Massaro +43 more
TL;DR: Catheter-based renal denervation can safely be used to substantially reduce blood pressure in treatment-resistant hypertensive patients and should be continued, according to the authors.
Journal ArticleDOI
Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study
Henry Krum,Markus P. Schlaich,Robert Whitbourn,Paul A. Sobotka,Jerzy Sadowski,Krzysztof Bartus,Bogusław Kapelak,Anthony Walton,Horst Sievert,S. Thambar,William T. Abraham,Murray D. Esler +11 more
TL;DR: In this article, a proof-of-principle trial of therapeutic renal sympathetic denervation in patients with resistant hypertension (i.e., systolic blood pressure ≥160 mm/hg on three or more antihypertensive medications, including a diuretic) was conducted to assess safety and blood-pressure reduction effectiveness.
Book
Neural Control Of Renal Function
Gerald F. DiBona,Ulla C. Kopp +1 more
TL;DR: The renal nerve is the communication link between the central nervous system and the kidney as discussed by the authors, which is the major structural and functional components of the kidney, the vessels, glomeruli, and tubules, each of which is innervated.
Journal Article
Response to Letter to the Editor: Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of principle cohort study
TL;DR: Catheter-based renal denervation causes substantial and sustained blood-pressure reduction, without serious adverse events, in patients with resistant hypertension, in a proof-of-principle trial of therapeutic renal sympathetic denervation.
Journal ArticleDOI
Renal Sympathetic-Nerve Ablation for Uncontrolled Hypertension
TL;DR: The renal sympathetic nerves have been identified as a major contributor to the complex pathophysiology of hypertension in both experimental models and in humans and may be modulated by afferent signaling from renal sensory nerves.
Related Papers (5)
Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): A randomised controlled trial
Murray D. Esler,Henry Krum,Paul A. Sobotka,Markus P. Schlaich,Roland E. Schmieder,Michael Böhm,Felix Mahfoud,Horst Sievert,Nina Wunderlich,Lars Christian Rump,Oliver Vonend,Michael Uder,Mel Lobo,Mark J. Caulfield,Andrejs Erglis,Michel Azizi,Marc Sapoval,S. Thambar,Alexandre Persu,Jean Renkin,Heribert Schunkert,Joachim Weil,Uta C. Hoppe,Tony Walton,Dierk Scheinert,Thomas Binder,Andrzej Januszewicz,Adam Witkowski,Luis M. Ruilope,Robert Whitbourn,Heike Bruck,Mark Downes,Thomas F. Lüscher,Alan G. Jardine,Mark Webster,Thomas Zeller,Jerzy Sadowski,Krzysztof Bartus,Craig A. Straley,Neil C. Barman,David P. Lee,Ronald M. Witteles,Vivek Bhalla,Joseph M. Massaro +43 more