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Failure of Antihypertensive Treatment to Restore Normal Sympathetic Activity
Fosca Quarti-Trevano1,2, Gino Seravalle3, Rita Facchetti4
1University Milano-Bicocca, Milan, Italy (F.Q.T.).
Antihypertensive drugs lower blood pressure but do not normalize muscle sympathetic nerve traffic (MSNA) in essential hypertension patients. This persistent sympathetic overdrive may explain residual cardiovascular risk in treated hypertensives.
Area of Science:
- Cardiology
- Hypertension Research
- Neuroscience
Background:
- Sympathetic nervous system overactivity is a key factor in hypertension.
- The efficacy of antihypertensive treatments in normalizing sympathetic activity is not fully understood.
Purpose of the Study:
- To investigate whether antihypertensive drug treatment normalizes muscle sympathetic nerve traffic (MSNA) in patients with essential hypertension.
Main Methods:
- Analyzed blood pressure (BP), heart rate, and MSNA using microneurography in 219 hypertensive patients and 100 controls.
- Assessed changes after 3 months of monotherapy or combination antihypertensive treatment.
Main Results:
- Antihypertensive treatment significantly reduced BP and MSNA.
- Despite BP control, MSNA remained significantly higher in treated patients compared to normotensive controls.
- MSNA levels were higher even when BP targets (<140/90 mmHg or <130/80 mmHg) were achieved.
Conclusions:
- Antihypertensive treatment fails to restore normotension-related MSNA levels.
- Persistent sympathetic hyperactivity in treated hypertensive patients may contribute to residual cardiovascular risk.
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