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Cited by 215Blood Pressure and Hypertension StudiesHeart Rate Variability and Autonomic ControlCardiovascular Health and Disease Prevention

Relationship between central sympathetic activity and stages of human hypertension

Smith, P·2004·American Journal of Hypertension
DOI 10.1016/j.amjhyper.2003.10.010
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Abstract

BACKGROUND: The magnitude of sympathetic hyperactivity in essential hypertension (EHT) varies with its severity and complications. There are no data on sympathetic nerve activity in borderline (BHT) or white-coat hypertension (WHT) relative to the various stages of EHT, despite suggestions that both lead to established EHT and organ damage through sympathetic mechanisms. We planned to determine the magnitude of sympathetic nerve activity in patients with BHT and WHT in relation to normality and various stages of sustained EHT. METHODS: We examined 90 untreated subjects comprising matched groups with BHT (n = 13), WHT (n = 12), Sixth Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure EHT stage 1 (EHT-1 n = 12), EHT stages 2 and 3 (EHT-2/3 n = 14), high-normal pressure (HN n = 14), and normal pressure (NT n = 13), as well as a group with EHT complicated by left ventricular hypertrophy (EHT+LVH n = 12). We quantified muscle sympathetic nerve activity as the mean frequency of multiunit discharge (MSNA) and that of single-units (s-MSNA). RESULTS: We found a greater (at least P <.01) mean central sympathetic frequency in BHT (75 +/- 5.8 impulses/100 beats), EHT-1 (76 +/- 4.0 impulses/100 beats), and EHT+LVH (79 +/- 4.3 impulses/100 beats) than in EHT-2/3 (57 +/- 3.1 impulses/100 beats), WHT (52 +/- 3.6 impulses/100 beats), HN (42 +/- 3.9 impulses/100 beats), and NT (33 +/- 3.6 impulses/100 beats). BHT hyperactivity was closer to that of EHT, whereas WHT was closer to NT. CONCLUSIONS: Central sympathetic activity was greatest in BHT, early stage, and complicated EHT, and as such is likely to play an integral role in the development of hypertension and its complications. Sympathetic hyperactivity occurs in WHT, but to a lesser extent than in BHT.

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  • Microneurographic studies almost universally show that sympathetic nerve traffic is potentiated in established hypertension in middle age and in elderly as well as young patients.

    “As far as the second issue is concerned, microneurographic studies almost universally shown that sympathetic nerve traffic is potentiated in established hypertension in middle age and in elderly as well as young patients38–46.”

    From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [43]

  • The sympathetic neural outflow is commonly activated also to the heart and skeletal muscle vasculature, but renal sympathetic activation is central to hypertension pathogenesis.

    “The sympathetic neural outflow is commonly activated also to the heart, shown with selective cardiac norepinephrine spillover measurements28, and to the skeletal muscle vasculature, demonstrated with microneurographic nerve traffic recording32,33,38–46, but it is the renal sympathetic activation which is central to hypertension pathogenesis96–97.”

    From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [43]

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Authors
Smith, P.
Affiliations
Leeds Teaching Hospitals NHS Trust (GB)
Corresponding author
Smith, P
Venue
American Journal of Hypertension
Publisher
Oxford University Press (OUP)
Published
2004-03
Volume
17
Issue
3
Pages
217-222
ISSN
0895-7061 (ISSN-L)
DOI
10.1016/j.amjhyper.2003.10.010
OpenAlex
W2158752804
Cited by
215
References
36
Citations by year
2026: 3 · 2025: 4 · 2024: 11 · 2023: 12 · 2022: 8 · 2021: 7 · 2020: 8 · 2019: 5 · 2018: 12 · 2017: 15 · 2016: 12 · 2015: 18 · 2014: 27 · 2013: 19 · 2012: 12
FWCI
3.27
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
essential hypertension, sympathetic activity, muscle sympathetic nerve activity, borderline hypertension, white coat hypertension, hypertension severity, left ventricular hypertrophy, sympathetic hyperactivity, hypertension stage, single-unit discharge
MeSH terms
Adult, Blood Pressure, Electrocardiography, Female, Heart Rate, Humans, Hypertension, Male, Middle Aged, Muscles, Severity of Illness Index, Statistics as Topic, Sympathetic Nervous System, Vasoconstriction, Hypertrophy, Left Ventricular

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