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
Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms.
TL;DR: With prolonged obesity and development of target organ injury, obesity-associated hypertension becomes more difficult to control, often requiring multiple antihypertensive drugs and treatment of other risk factors, including dyslipidemia, insulin resistance and diabetes mellitus, and inflammation.
Patent
Methods and apparatus for renal neuromodulation
Mark Deem,Hanson S. Gifford,Denise Zarins,Douglas Sutton,Erik Thai,Mark Gelfand,Howard R. Levin +6 more
TL;DR: In this article, a pulsed electric field was used to induce electroporation or electrofusion of percutaneous intravascular vessels to reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease.
Patent
Renal nerve stimulation method and apparatus 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 paper, where the goal is to reduce the sympathetic activity of renal nerve.
Patent
Methods and apparatus for thermally-induced renal neuromodulation
TL;DR: In this article, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy, where the parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors.
Patent
Methods and apparatus for performing a non-continuous circumferential treatment to a body lumen
Denise Demarais,Hanson S. Gifford,Nicolas Zadno,Mark Deem,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.
References
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Journal ArticleDOI
Neural Control of the Kidney: Past, Present, and Future
TL;DR: This article provides a chronological perspective on the development of knowledge concerning the neural control of renal function and is divided into three parts: the past, the present, and the future.
Journal ArticleDOI
Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension
Felix Mahfoud,Bodo Cremers,Julia Janker,Britta Link,Oliver Vonend,Christian Ukena,Dominik Linz,Roland E. Schmieder,Lars Christian Rump,Ingrid Kindermann,Paul A. Sobotka,Henry Krum,Bruno Scheller,Markus P. Schlaich,Ulrich Laufs,Michael Böhm +15 more
TL;DR: RD reduced blood pressure, renal resistive index, and incidence of albuminuria without adversely affecting glomerular filtration rate or renal artery structure within 6 months and appears to be a safe and effective therapeutic approach to lower blood pressure in patients with resistant hypertension.
Journal ArticleDOI
Carotid Baroreceptor Stimulation, Sympathetic Activity, Baroreflex Function, and Blood Pressure in Hypertensive Patients
Karsten Heusser,Jens Tank,Stefan Engeli,André Diedrich,Jan Menne,Siegfried Eckert,Tim J Peters,Fred C.G.J. Sweep,Hermann Haller,Andreas M. Pichlmaier,Friedrich C. Luft,Jens Jordan +11 more
TL;DR: Electric field stimulation of carotid sinus baroreflex afferents acutely decreased arterial blood pressure in hypertensive patients, without negative effects on physiological barore Flex regulation.
Journal ArticleDOI
Renal Denervation in Moderate to Severe CKD
Dagmara Hering,Felix Mahfoud,Antony Walton,Henry Krum,Gavin Lambert,Elisabeth Lambert,Paul A. Sobotka,Michael Böhm,Bodo Cremers,Murray D. Esler,Murray D. Esler,Markus P. Schlaich,Markus P. Schlaich +12 more
TL;DR: A favorable short-term safety profile and beneficial BP effects of catheter-based renal nerve ablation in patients with stage 3-4 CKD and resistant hypertension are suggested.
Journal ArticleDOI
Substantial Reduction in Single Sympathetic Nerve Firing After Renal Denervation in Patients With Resistant Hypertension
Dagmara Hering,Elisabeth Lambert,Elisabeth Lambert,Petra Marusic,Antony Walton,Henry Krum,Gavin Lambert,Gavin Lambert,Murray D. Esler,Murray D. Esler,Markus P. Schlaich,Markus P. Schlaich,Markus P. Schlaich +12 more
TL;DR: RDN results in the substantial and rapid reduction in firing properties of single sympathetic vasoconstrictor fibers, this being more pronounced than multi-unit MSNA inhibition.
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