Sympathetic nervous system, diabetes, and hypertension
1Department of Internal Medicine, University of Turin, Torino, Italy. paolo.cavalloperin@unito.it
Summary
Diabetic patients have higher hypertension rates due to sympathetic nerve overactivity. This overactivity, linked to kidney issues or metabolic syndrome, increases cardiovascular risk, necessitating targeted treatments.
Area of Science:
- Cardiology
- Endocrinology
- Nephrology
Background:
- Hypertension is prevalent in diabetic individuals, occurring twice as often compared to the general population.
- Hypertension is more common in Type 2 diabetes, often preceding diagnosis, while in Type 1 diabetes, it's linked to nephropathy.
- Sympathetic nerve overactivity plays a key role in hypertension development in diabetes.
Purpose of the Study:
- To explore the role of sympathetic overactivity in hypertension pathogenesis in diabetic patients.
- To discuss the mechanisms linking sympathetic overactivity to hypertension in different diabetes types.
- To review therapeutic strategies for hypertension in diabetic subjects, considering their impact on sympathetic activity.
Main Methods:
- Review of existing literature on hypertension in diabetes.
- Analysis of the role of the renin-angiotensin-aldosterone system and insulin resistance.
- Examination of the impact of autonomic neuropathy and reduced nocturnal dipping.
Main Results:
- Sympathetic overactivity can stem from renin-angiotensin-aldosterone system activation in Type 1 diabetes with renal failure or insulin resistance in Type 2 diabetes with metabolic syndrome.
- Vagal impairment in autonomic neuropathy shifts sympatho-vagal balance, contributing to hypertension, often preceded by reduced nocturnal blood pressure dipping.
- Sympathetic overactivity increases cardiovascular risk through enhanced renin-angiotensin-aldosterone system activity, sodium reabsorption, and elevated heart rate, stroke volume, and vascular resistance.
Conclusions:
- Sympathetic overactivity is a critical factor in hypertension among diabetic patients, with distinct underlying mechanisms in Type 1 and Type 2 diabetes.
- Autonomic dysfunction, particularly vagal impairment, significantly contributes to hypertension and cardiovascular risk in diabetes.
- Pharmacological interventions targeting sympathetic activity are available, but their metabolic benefits remain debated.
More Related Videos
08:47Live Images of GLUT4 Protein Trafficking in Mouse Primary Hypothalamic Neurons Using Deconvolution Microscopy
Published on: December 7, 2017
06:30Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats
Published on: September 11, 2018
Related Concept Videos
01:25The Sympathetic Nervous System
Overview
01:16Sympathetic Activation
The sympathetic division can influence tissues and organs by releasing norepinephrine at peripheral synapses and distributing epinephrine and norepinephrine through the bloodstream. In times of crisis or stress, sympathetic activation occurs, which is regulated by sympathetic centers in the hypothalamus. As a result, sympathetic activation prepares the body for physical exertion, rapid ATP production, and heightened alertness, allowing individuals to respond effectively to challenging or...
01:18Disorders of the Autonomic Nervous System
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Raynaud's disease, also known as Raynaud's phenomenon, is a...
01:18Neural Regulation of Blood Pressure
The neural regulation of blood pressure involves intricate interactions between the autonomic nervous system (ANS) and cardiovascular system, ensuring adequate perfusion of tissues. This regulation primarily occurs through baroreceptor and chemoreceptor reflexes, involving both short-term and long-term mechanisms.
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
01:29Hypertension II: Pathophysiology
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
01:19Psychoneuroimmunology: Diabetes and Cancer
Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...