Autonomic Nervous System Dysregulation in Metabolic Syndrome: An Association With Hypertension and Cardiovascular...

Area of Science:

• Cardiology
• Endocrinology
• Neuroscience

Background:

• Metabolic syndrome (MetS) involves abdominal obesity, insulin resistance, dyslipidemia, and hypertension, elevating risks for type 2 diabetes and cardiovascular disease (CVD).
• Autonomic imbalance, with heightened sympathetic and reduced parasympathetic activity, is implicated in hypertension and adverse cardiovascular events within MetS.

Purpose of the Study:

• To systematically review and evaluate the association between autonomic nervous system (ANS) dysregulation and Metabolic Syndrome (MetS).

Main Methods:

• A systematic search of PubMed, Embase, Scopus, and Cochrane Library (January 2015–September 2025) was performed.
• Included studies examined ANS function markers (HRV, baroreflex sensitivity, sympathetic nerve activity, catecholamines) in MetS individuals.
• 16 observational and interventional studies were included and data synthesized narratively.

Main Results:

• Most studies reported reduced heart rate variability (HRV), impaired baroreflex sensitivity, increased sympathetic nerve activity, and elevated plasma catecholamines in MetS participants.
• A consistent association was found between ANS dysregulation and elevated blood pressure in MetS.
• Causality could not be established due to the observational nature of most studies.

Conclusions:

• Significant evidence links autonomic dysfunction to MetS, particularly concerning hypertension and increased cardiovascular risk.
• ANS biomarkers may aid in refining cardiometabolic risk stratification.
• Further prospective and mechanistic studies are required to elucidate causal pathways.