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Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension
Abstract
Hypertension is a major cardiovascular risk factor in the metabolic syndrome (MS) in which the presence of insulin resistance, glucose intolerance, abnormal lipoprotein metabolism, and central obesity all confer an increased risk. Because essential hypertension (EHT), insulinemia, and visceral fat are associated with sympathetic hyperactivity, which is itself known to increase cardiovascular risk, the aim of this study was to see if MS is a state of sympathetic nerve hyperactivity and if the additional presence of EHT intensifies this hyperactivity. In 69 closely matched subjects, comprising hypertensive MS (MS+EHT, 18), normotensive MS (MS-EHT, 17), hypertensives without MS (EHT, 16), and normotensive controls without MS (NC, 18), we measured resting muscle sympathetic nerve activity (MSNA) as assessed from multiunit discharges and from single units with defined vasoconstrictor properties (s-MSNA). The s-MSNA in MS+EHT (76±3.1 impulses/100 beats) was greater (at least P <0.01) than in MS-EHT (62±3.2 impulses/100 beats) and in EHT (60±2.3 impulses/100 beats), and all these were significantly greater (at least P <0.01) than in NC (46±2.7 impulse/100 beats). The multi-unit MSNA followed a similar trend. These findings suggest that MS is a state of sympathetic nerve hyperactivity and that the additional presence of hypertension further intensifies this hyperactivity. The degree of sympathetic hyperactivity seen in this study could be argued at least partly to contribute to the higher cardiovascular risk and metabolic abnormalities seen in MS+EHT patients.
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TL;DR
In nondiabetic metabolic syndrome, resting sympathetic nerve activity is increased, and the additional presence of hypertension further augments it. The authors conclude this sympathetic hyperactivity may contribute to higher cardiovascular risk and metabolic abnormalities in MS+EHT.
Key findings
- Resting single-unit muscle sympathetic nerve activity (s-MSNA) was 76±3.1 impulses/100 beats in MS+EHT, greater than 62±3.2 in MS-EHT and 60±2.3 in EHT (at least P<0.01), and all three groups exceeded NC at 46±2.7 impulses/100 beats (at least P<0.01); multiunit MSNA followed a similar trend.
- MS+EHT had the highest sympathetic activity, significantly greater than MS-EHT, which was similar to EHT; s-MSNA hyperactivity was increased by ≈65% in MS+EHT and ≈35% in MS-EHT versus NC.
- MS groups had greater fasting glucose, insulin, HOMA-IR, triglycerides, and lower HDL cholesterol than EHT and NC; the only difference between MS+EHT and MS-EHT was slightly greater triglycerides in MS+EHT.
- Plasma insulin and HOMA-IR positively correlated with s-MSNA and MSNA in MS+EHT (r 0.41–0.45; at least P<0.04) and MS-EHT (r 0.49–0.53; at least P<0.02); no significant correlations were found with waist circumference, waist/hip ratio, fasting glucose, triglycerides, or HDL (r −0.34 to 0.42; at least P>0.05).
Methods
- Cross-sectional comparison of 69 white subjects with complete data (from 72 examined; 3 excluded because stable single-unit microneurographic data could not be obtained): MS+EHT n=18, MS-EHT n=17, EHT n=16, NC n=18. MS was defined by NCEP ATP III criteria; diabetes was excluded.
- Resting postganglionic muscle sympathetic nerve activity was recorded from the right peroneal nerve by microneurography, quantified as multiunit MSNA and single-unit s-MSNA with vasoconstrictor properties; simultaneous ECG, Finometer arterial pressure, strain-gauge calf blood flow, and calf vascular resistance were measured, and baroreceptor reflex sensitivity was obtained from Valsalva.
- One-way ANOVA with Newman-Keuls post-tests compared groups; least-square technique assessed linear relationships; P<0.05 was significant; data are mean±SEM.
Limitations
- Stated: antihypertensive therapy differed between groups and was not withdrawn; the authors state they cannot entirely exclude an influence of ACE inhibitors, ARBs, thiazide diuretics, or beta-blockers, although they argue these agents could not entirely cause the excessive sympathetic hyperactivity.
- Stated: findings may not extrapolate beyond white subjects because insulinemia and sympathetic nerve activity can differ by ethnicity; the authors also state there may be differences in sympathetic output to regions other than the leg.
- Stated/evident: the study is cross-sectional and the authors state their findings do not establish a causal relationship between MS and sympathetic activity; no longitudinal or interventional causal test was performed.
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31 Not checked yet · 16 Own result · 9 Own method · 7 Own interpretation
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The s-MSNA in MSϩEHT (76Ϯ3.1 impulses/100 beats) was greater (at least PϽ0.01) than in MS-EHT (62Ϯ3.2impulses/100 beats) and in EHT (60Ϯ2.3impulses/100 beats), and all these were significantly greater (at least PϽ0.01) than in NC (46Ϯ2.7 impulse/100 beats).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
plaincorrelationaln = 69 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: s-MSNA reflects the mean resting sympathetic nerve frequency supplying the peripheral vessels.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The s-MSNA in MSϩEHT (76Ϯ3.1 impulses/100 beats) was greater (at least PϽ0.01) than in MS-EHT (62Ϯ3.2impulses/100 beats) and in EHT (60Ϯ2.3impulses/100 beats), and all these were significantly greater (at least PϽ0.01) than in NC (46Ϯ2.7 impulse/100 beats).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: s-MSNA reflects the mean resting sympathetic nerve frequency supplying the peripheral vessels.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The s-MSNA in MSϩEHT (76Ϯ3.1 impulses/100 beats) was greater (at least PϽ0.01) than in MS-EHT (62Ϯ3.2impulses/100 beats) and in EHT (60Ϯ2.3impulses/100 beats), and all these were significantly greater (at least PϽ0.01) than in NC (46Ϯ2.7 impulse/100 beats).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: s-MSNA reflects the mean resting sympathetic nerve frequency supplying the peripheral vessels.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The multi-unit MSNA followed a similar trend.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
plainn = 69- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The s-MSNA in MSϩEHT (76Ϯ3.1 impulses/100 beats) was greater (at least PϽ0.01) than in MS-EHT (62Ϯ3.2impulses/100 beats) and in EHT (60Ϯ2.3impulses/100 beats), and all these were significantly greater (at least PϽ0.01) than in NC (46Ϯ2.7 impulse/100 beats).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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- Rests on an assumption: s-MSNA reflects the mean resting sympathetic nerve frequency supplying the peripheral vessels.
None of the sources cited for this claim have been checked yet.
In the paper
“As previously shown in hypertensive and normotensive populations, 4,7 there was no significant correlation within any of the groups between sympathetic nerve activity and arterial pressure (at least PϾ0.06).”
- Also stated in: § Discussion · plain
“Also, there was no correlation between sympathetic nerve activity and arterial pressure as has previously been documented.4,7”
- Also stated in: § Discussion · boosted
“In this respect, and as we observed, it has been known that there is no significant correlation between vasoconstrictor MSNA and arterial pressure levels.4,7”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
What the sources say
- Not checked yetcites [4]
- Not checked yetcites [7] source
boosted- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The s-MSNA in MSϩEHT (76Ϯ3.1 impulses/100 beats) was greater (at least PϽ0.01) than in MS-EHT (62Ϯ3.2impulses/100 beats) and in EHT (60Ϯ2.3impulses/100 beats), and all these were significantly greater (at least PϽ0.01) than in NC (46Ϯ2.7 impulse/100 beats).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: s-MSNA reflects the mean resting sympathetic nerve frequency supplying the peripheral vessels.
None of the sources cited for this claim have been checked yet.
In the paper
“Sympathetic activity indices showed a significant correlation to age in each of the 4 groups (r between 0.5 and 0.70; at least PϽ0.02) as has previously been reported.4,7”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
What the sources say
- Not checked yetcites [4]
- Not checked yetcites [7] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Only plasma insulin levels and HOMA-IR showed significant positive correlation to s-MSNA and MSNA (Figure 3) in both MSϩEHT (r between 0.41 and 0.45; at least PϽ0.04) and MS-EHT patients (r between 0.49 and 0.53; at least PϽ0.02).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“There were no significant correlation between sympathetic activity indices and waist circumference, waist/hip ratio, fasting glucose, triglycerides, or HDL cholesterol levels (r between Ϫ0.34 and 0.42; at least PϾ0.05).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plain- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 18
- The quote only partly states this claim. 1
- Probably not a substantial claim. 15
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In the paper
“The EHT groups had lower baroreceptor reflex sensitivity than the other 2 groups as previously reported.4,7”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
What the sources say
- Not checked yetcites [4]
- Not checked yetcites [7] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one. The quote only partly states this claim.
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In the paper
“Despite the vasodilating agents taken by the hypertensive groups, the level of CVR showed differences that were in concert with the sympathetic hyperactivity observed, being highest in MSϩEHT and greater in MS-EHT and EHT than NC (Table 2).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The mean frequency of s-MSNA and MSNA per minute and per 100 cardiac beats was significantly greater in MS-EHT and MSϩEHT than in NC (Table, 2; Figure 2).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The MS groups (MSϩEHT and MS-EHT) had greater fasting glucose, insulin, HOMA-IR, triglycerides, and lower HDL cholesterol than the EHT and NC groups (Table 1).”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The s-MSNA hyperactivity of MSϩEHT and MS-EHT was increased by Ϸ65% and 35%, respectively, when compared with that in NC.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The MSϩEHT group had the highest sympathetic activity level, and this was significantly greater than that in MS-EHT, which in turn was similar to that in EHT.”
- Also stated in: § Discussion · plain
“Second, activation of vasoconstrictor sympathetic activity in MSϩEHT was greater than that seen in either EHT or MS-EHT alone.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the finding of increased peripheral sympathetic nerve activity in MS and its further augmentation by the presence of EHT”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Perspectives
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In the paper
“Insulin resistance was assessed by the previously validated 16,17 homeostasis model assessment (HOMA)”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Assays
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
In the paper
“However, the MSNA bursts contain different efferent units, including those recruited through the operation of reflex mechanisms, 4 and their data make our findings comparable with other publications in terms of potential confounding factors.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Microneurography
What the sources say
- Not checked yetcites [4]
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This was confirmed by simultaneous measurement of CBF and CVR.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Microneurography
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“In all subjects, the measured variables were obtained in an identical manner as has been published previously.4,7”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > General Protocol
What the sources say
- Not checked yetcites [4]
- Not checked yetcites [7] source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The intraobserver reproducibility of CBF measurement in this laboratory, obtained as twice 95% confidence interval of differences between repeated within-session plethysmography, amounted to 2.4% of the value of the measurement.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > General Protocol
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Sympathetic activation has already been associated with many of the individual components of the MS, such as visceral obesity, 5 insulinemia, 6 EHT, [1][2][3][4] and type 2 diabetes.7”
- Also stated in: § Abstract · plain
“Because essential hypertension (EHT), insulinemia, and visceral fat are associated with sympathetic hyperactivity”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
- Also stated in: § Abstract · plain
None of the sources cited for this claim have been checked yet.
In the paper
“sympathetic activation in EHT is believed to contribute to cardiovascular risk.13,14”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Abstract
What the sources say
- Not checked yetcites [13] source
- Not checked yetcites [14]
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Only vasoconstrictor discharge was accepted after showing appropriate responses to spontaneous arterial pressure changes, the Valsalva maneuver, isometric handgrip exercise, and cold pressor tests.4,7,19,20”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Microneurography
What the sources say
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Stable microneurographic data to obtain single unit activity could not be obtained in 3 subjects, and complete data were therefore obtained from 69 subjects.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Subjects
plainn = 69- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There may be differences in the sympathetic output to regions other than the leg in our patients.2,3”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
What the sources say
- Not checked yetcites [2]
- Not checked yetcites [3] source
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, it is noteworthy to mention that our results are consistent with other reported findings in conditions related to MS despite involving different populations, regions, and techniques.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Furthermore, the 4 groups had similar heart rate levels, thus minimizing its effect on sympathetic nerve activity.26”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
What the sources say
- Not checked yetcites [26] source
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Similar results were obtained when the data were analyzed according to gender or while separately excluding patients taking ACE inhibitors, ARBs, thiazide diuretics, and -blockers.”
- Also stated in: § Discussion · plain
“Analyzing the data in patients not taking ARB or -blocking agents did not affect our findings.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Results
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Also stated in: § Discussion · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These considerations are consistent with our findings of MS being a state of sympathetic nerve hyperactivity, particularly in the presence of hypertension.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These findings suggest that the metabolic abnormalities found in MS are associated with an enhanced sympathetic drive that is further intensified by the presence of hypertension.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Also, obesity in combination with EHT has been found to either increase MSNA 29 or have no effect.30”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
What the sources say
- Not checked yetcites [29]
- Not checked yetcites [30]
plainconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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In the paper
“Therefore, although we cannot completely exclude an effect of medications in our 2 hypertensive groups, they could not have entirely caused the excessive sympathetic hyperactivity.”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
What the sources say
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Although we cannot entirely exclude some influence of these agents, it is known in hypertensive patients that chronic ACE inhibitor therapy does not affect MSNA levels, 22 ARBs may decrease it, 23 and -blockers may have no effect or decrease MSNA.24,25”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
What the sources say
- Not checked yetcites [23] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Although we did not test the risk of, or differences in, regional sympathetic activation in our patients”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Perspectives
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“It is already known that MS or EHT patients have a high cardiovascular risk”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Perspectives
What the sources say
- Not checked yetcites [11] source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although we cannot entirely exclude some influence of these agents, it is known in hypertensive patients that chronic ACE inhibitor therapy does not affect MSNA levels, 22 ARBs may decrease it, 23 and -blockers may have no effect or decrease MSNA.24,25”
§ Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
s-MSNA reflects the mean resting sympathetic nerve frequency supplying the peripheral vessels.
“We measured both s-MSNA and MSNA frequencies because s-MSNA reflects the mean resting sympathetic nerve frequency supplying the peripheral vessels.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The presence of hypertension in addition to other components of the metabolic syndrome was associated with further increases in single fiber firing and multifiber muscle sympathetic nerve activity.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [73]
In the citing paper
“Huggett et al73 demonstrated that patients with metabolic syndrome without hypertension had increased muscle sympathetic nerve activity (specifically increased single fiber firing) when compared to a control group matched for body weight and lacking the metabolic syndrome.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [73]
Citations
Cites
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
Grundy, S. M., Becker, D. M., Clark, L. T., Cooper, R., Denke, M. A., Howard, J. L., Hunninghake, D. B., Illingworth, D. R., Luepker, R. V., McBride, P. E., et al. (2002) · Civil War Book Review · Cited by 12,198
Cardiovascular Morbidity and Mortality Associated With the Metabolic Syndrome
Isomaa, B., Almgren, P., Tuomi, T., Forsén, B., Lahti, K., Nissén, M., Taskinen, M.-R., & Groop, L. (2001) · Diabetes Care · doi:10.2337/diacare.24.4.683 · Cited by 4,760
Bonora, E., Targher, G., Alberiche, M., Bonadonna, R. C., Saggiani, F., Zenere, M. B., Monauni, T., & Muggeo, M. (2000) · Diabetes Care · doi:10.2337/diacare.23.1.57 · Cited by 2,456
The Gross Composition of the Body
Siri, W. E. (1956) · Advances in biological and medical physics · doi:10.1016/b978-1-4832-3110-5.50011-x · Cited by 1,773
Somatosensory, proprioceptive, and sympathetic activity in human peripheral nerves
Vallbo, A. B., Hagbarth, K. E., Torebjork, H. E., & Wallin, B. G. (1979) · Physiological Reviews · doi:10.1152/physrev.1979.59.4.919 · Cited by 1,507
Alexander, C. M., Landsman, P. B., Teutsch, S. M., & Haffner, S. M. (2003) · Diabetes · doi:10.2337/diabetes.52.5.1210 · Cited by 1,475
Reaven, G. M., Lithell, H., & Landsberg, L. (1996) · New England Journal of Medicine · doi:10.1056/nejm199602083340607 · Cited by 1,435
Cited by
Sorted by citations
Items 201–210 of 210
Physical Activity, Stress, and Obesity
Holmes, M. E. (2016) · Springer eBooks · doi:10.1007/978-3-662-49411-0_13-1
Cardiovascular Risk Factors in Adolescents
Khaddam, A. (2021) · Springer eBooks · doi:10.1007/978-3-030-36811-1_125
Chen, W., Yang, Y., Duan, J., Li, M., Tang, Y., Zhang, S., Gong, H., Li, Q., & Wang, Y. (2020) · doi:10.21203/rs.3.rs-82525/v1
Bhasi, A., Puri, O., Pathania, M., Saha, S., Dhar, M., & Kulshreshta, P. (2023) · medRxiv · doi:10.1101/2023.11.15.23298569
Miyazaki, H., Nishio, Y., Miyahara, K., Furutani, C., Xu, Z., Saeki, N., Tsuji, T., & Okada, Y. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e23121
Autonomic Dysfunction in Hypertension
Parati, G., & Ochoa, J. E. (2023) · Springer eBooks · doi:10.1007/978-3-031-43036-7_3 · Cited by 1
Peng, X., Shi, X., & Warren, A. (2007) · INFM-OAR (INFN Catania) · doi:10.5281/zenodo.177494
Alouane, L. (2012) · theses.fr (ABES) · doi:10.70675/daadca28z0435z40b0z91f6zc366c49c0b24
Experimental Models for Studying Cardiovascular Dysfunction in Metabolic Syndrome
Taylor, J. L., da Silva, E. A. P., Voorhees, H. M., Ferrara, M. K., Salbato, S., Daghbouche-Rubio, N., Baudel, M. A. S. M., & Nieves‐Cintrón, M. (2026) · Handbook of experimental pharmacology · doi:10.1007/164_2026_800
Parati, G., Amir, A., Meguid, K. R. A. E., Sabbour, H. M., Centonze, C., Tsabedze, N., Haji, G. F., Perminova, A., Bennis, A., Koziolova, N. A., et al. (2026) · Current Medical Research and Opinion · doi:10.1080/03007995.2026.2682073 · Cited by 1
Metadata
- Authors
- Huggett, R. J., Burns, J., Mackintosh, A. F., & Mary, D. A. S. G.
- Affiliations
- St James's University Hospital (GB)
- ORCID
- Mackintosh, Alan F.
- Venue
- Hypertension
- Published
- 2004-12
- Volume
- 44
- Issue
- 6
- Pages
- 847-852
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2166344703
- Cited by
- 211
- References
- 44
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 7 · 2022: 5 · 2021: 8 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 10 · 2016: 15 · 2015: 15 · 2014: 15 · 2013: 10 · 2012: 17
- FWCI
- 8.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- metabolic syndrome, essential hypertension, muscle sympathetic nerve activity, cardiovascular risk, visceral fat, insulin resistance, non-diabetic patients
- MeSH terms
- Anthropometry, Blood Pressure, Electrodiagnosis, Female, Humans, Hypertension, Male, Middle Aged, Sympathetic Nervous System, Metabolic Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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