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Autonomic imbalance, hypertension, and cardiovascular risk

R D Brook1, S Julius

  • 1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0356, USA.

American Journal of Hypertension
|August 2, 2000
PubMed

Insights

Essential hypertension increases cardiovascular risk due to autonomic imbalance. Targeting high sympathetic tone with metabolically beneficial antihypertensive drugs is a reasonable clinical approach for patients with metabolic syndrome.

Area of Science:

  • Cardiology
  • Autonomic Neuroscience
  • Metabolic Syndrome

Background:

  • Essential hypertension is linked to increased cardiovascular morbidity and mortality.
  • Autonomic imbalance, particularly high sympathetic tone, contributes to hypertension's development and cardiac risks.
  • Sympathetic overactivity underlies metabolic, hemodynamic, and rheologic abnormalities in hypertension.

Purpose of the Study:

  • To investigate the role of autonomic imbalance in essential hypertension.
  • To explore methods for clarifying prereceptor versus receptor abnormalities in insulin resistance.
  • To evaluate the clinical utility of antihypertensive drugs in managing hypertension-related complications.

Main Methods:

  • Review of existing literature on autonomic function in hypertension.
  • Analysis of the contribution of sympathetic tone to hypertensive abnormalities.
  • Consideration of clinical trial data and therapeutic strategies.

Main Results:

  • Autonomic imbalance and high sympathetic tone are common in essential hypertension.
  • Sympathetic overactivity is implicated in various metabolic and hemodynamic derangements.
  • Further research is needed on newer antihypertensive medications.

Conclusions:

  • Antihypertensive drugs that reduce sympathetic overactivity and offer metabolic benefits are a viable option.
  • This approach is particularly relevant for hypertensive patients with metabolic syndrome or autonomic imbalance.
  • Clinical trials evaluating newer medications are ongoing but results are pending.

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