Neuroadrenergic disarray in pseudo-resistant and resistant hypertension
Guido Grassi1, Michele Bombelli2, Silvia Buzzi2
11] Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Monza, Italy [2] IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
Summary
Essential hypertension involves adrenergic activation. This review examines sympathetic nervous system activity in resistant hypertension, exploring interventions for this condition.
Area of Science:
- Cardiovascular Physiology
- Nephrology
- Clinical Pharmacology
Background:
- Essential hypertension is characterized by adrenergic activation, contributing to its development and end-organ damage.
- Sympathetic nervous system (SNS) behavior in resistant hypertension is less understood than in essential hypertension.
- Neuroadrenergic overdrive plays a role in hypertension progression and related organ damage.
Purpose of the Study:
- To review current knowledge on sympathetic nervous system activity in resistant hypertension.
- To analyze data from direct and indirect methods assessing adrenergic function in resistant hypertension.
- To evaluate the impact of interventions on adrenergic function in resistant hypertension.
Main Methods:
- Review of existing literature on sympathetic cardiovascular drive in hypertension.
- Examination of studies using indirect approaches to assess adrenergic function.
- Analysis of studies employing direct methods to investigate SNS activity.
- Evaluation of pharmacological and non-pharmacological intervention effects.
Main Results:
- Essential hypertension shows clear evidence of adrenergic activation.
- Neuroadrenergic overdrive is implicated in hypertension development, progression, and end-organ damage.
- Data on SNS activity in resistant hypertension is limited but crucial.
Conclusions:
- Adrenergic activation is a hallmark of essential hypertension.
- Further research is needed to fully understand SNS behavior in resistant hypertension.
- Interventions targeting the SNS may be beneficial for resistant hypertension management.
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