Sympathetic nervous system: role in hypertension and in chronic kidney disease
Abstract
PURPOSE OF REVIEW: A number of cardiovascular disease have been shown to be characterized by a marked increase in sympathetic drive to the heart and peripheral circulation. This is the case for essential hypertension, congestive heart failure, obesity, metabolic syndrome and chronic renal failure. This review focuses on the most recent findings documenting the role of sympathetic neural factors in the development and progression of the hypertensive state as well as of target organ damage. It also reviews the participation of sympathetic neural factors in the development of the earlier stages of renal failure. RECENT FINDINGS: A marked increase in sympathetic neural discharge, as assessed via the microneurographic technique, has been shown to occur in the predialytic stage of chronic renal failure. Recent evidence, however, indicates that also in the earlier clinical phases of kidney disease, sympathetic activation is detectable. Further data show that sympathetic neural mechanisms participate in renal and/or hypertensive disease progression, favouring the development of target organ damage. Finally, recent findings indicate that the metabolic disarray frequently complicating the high blood pressure state (metabolic syndrome, dislipidemia, insulin resistance) may have as pathophysiological background a sympathetic overdrive. Altogether these data represent the rationale for employing in hypertension (and particularly in resistant hypertension) therapeutic interventions such as carotid baroreceptor stimulation and renal denervation, capable of exerting sympathoinhibitory effects. SUMMARY: The sympathetic nervous system represents a major pathophysiological hallmark of both hypertension and renal failure and is an important target for the therapeutic intervention.
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Human sympathetic nervous system dysfunction plays an important role in the development and progression of hypertension, heart failure, and CKD.
“Human sympathetic nervous system dysfunction plays an important role in the development and progression of hypertension, heart failure, and CKD.398,399”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [399]
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- Authors
- Grassi, G., Bertoli, S., & Seravalle, G.
- Affiliations
- Azienda Ospedaliera San Gerardo (IT)
- MultiMedica (IT)
- IRCCS Istituto Auxologico Italiano (IT)
- Corresponding author
- Grassi, Guido
- Venue
- Current Opinion in Nephrology & Hypertension
- Published
- 2012-01
- Volume
- 21
- Issue
- 1
- Pages
- 46-51
- ISSN
- 1062-4821 (ISSN-L)
- OpenAlex
- W1967477492
- Cited by
- 118
- References
- 50
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 9 · 2019: 9 · 2018: 7 · 2017: 7 · 2016: 14 · 2015: 6 · 2014: 18 · 2013: 9 · 2012: 12
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Nephrology & Hypertension (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- 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 › Renin-Angiotensin System Studies
- Keywords
- sympathetic nervous system, essential hypertension, chronic kidney disease, target organ damage, metabolic syndrome, insulin resistance, resistant hypertension, carotid baroreceptor stimulation, renal denervation, congestive heart failure, obesity
- MeSH terms
- Animals, Cardiovascular System, Chronic Disease, Electric Stimulation Therapy, Humans, Hypertension, Kidney, Kidney Diseases, Phenotype, Sympathectomy, Sympathetic Nervous System, Baroreflex, Neurotransmitter Agents, Genetic Predisposition to Disease
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