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
More filters
Patent
System and method for performing renal denervation verification
TL;DR: In this article, a renal denervation feedback method is described that performs a baseline measurement of renal nerve plexus electrical activity at a renal vessel; denervates at least some tissue proximate the renal vessel after performing the baseline measurement; performs a post-denervation measurement, after the denervating; and assesses denervation of the kidney vessel based on a comparison of the baseline measurements and the post denervation measurements.
Patent
Apparatus for performing a non-continuous circumferential treatment of a body lumen
Denise Demarais,Hanson S. Gifford,Mark Deem,Nicolas Zadno,Benjamin J. Clark,Andrew Wu,Kenneth J. Michlitsch +6 more
TL;DR: In this article, a non-continuous circumferential treatment of a body lumen is described, where an apparatus is used to deliver energy at a first lengthwise and angular position within the lumen to create a less-than-full treatment zone at the first position.
Journal ArticleDOI
Sex Differences in the Developmental Origins of Cardiovascular Disease
TL;DR: A review will highlight the potential mechanisms that contribute to the etiology of sex differences in the developmental programming of cardiovascular disease.
Journal ArticleDOI
Metabolic dysfunction in obstructive sleep apnea: A critical examination of underlying mechanisms
TL;DR: Despite many studies linking each of these individual components of OSA to the development of metabolic syndrome, there are very few reports that actually provide a coherent narrative about the mechanism underlying metabolic dysfunction in OSA.
Journal ArticleDOI
Long-term sympathoinhibitory effects of surgically induced weight loss in severe obese patients
Gino Seravalle,Manuela Colombo,Paolo Perego,Vittorio Giardini,Marco Volpe,Raffaella Dell'Oro,Giuseppe Mancia,Guido Grassi +7 more
TL;DR: Evidence is provided that massive weight loss induced by sleeve gastrectomy triggers profound sympathoinhibitory effects, associated with a stable and significant reduction in plasma leptin levels, whereas the improvement in insulin sensitivity was attenuated with time and unrelated to the sympathoinhibition.
References
More filters
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