Adrenergic and Reflex Abnormalities in Obesity-Related Hypertension
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Abstract —Previous studies have shown that essential hypertension and obesity are both characterized by sympathetic activation coupled with a baroreflex impairment. The present study was aimed at determining the effects of the concomitant presence of the 2 above-mentioned conditions on sympathetic activity as well as on baroreflex cardiovascular control. In 14 normotensive lean subjects (aged 33.5±2.2 years, body mass index 22.8±0.7 kg/m 2 [mean±SEM]), 16 normotensive obese subjects (body mass index 37.2±1.3 kg/m 2 ), 13 lean hypertensive subjects (body mass index 24.0±0.8 kg/m 2 ), and 16 obese hypertensive subjects (body mass index 37.5±1.3 kg/m 2 ), all age-matched, we measured beat-to-beat arterial blood pressure (by Finapres device), heart rate (HR, by ECG), and postganglionic muscle sympathetic nerve activity (MSNA, by microneurography) at rest and during baroreceptor stimulation and deactivation induced by stepwise intravenous infusions of phenylephrine and nitroprusside, respectively. Blood pressure values were higher in lean hypertensive and obese hypertensive subjects than in normotensive lean and obese subjects. MSNA was significantly ( P <0.01) greater in obese normotensive subjects (49.1±3.0 bursts per 100 heart beats) and in lean hypertensive subjects (44.5±3.3 bursts per 100 heart beats) than in lean normotensive control subjects (32.2±2.5 bursts per 100 heart beats); a further increase was detectable in individuals with the concomitant presence of obesity and hypertension (62.1±3.4 bursts per 100 heart beats). Furthermore, whereas in lean hypertensive subjects, only baroreflex control of HR was impaired, in obese normotensive subjects, both HR and MSNA baroreflex changes were attenuated, with a further attenuation being observed in obese hypertensive patients. Thus, the association between obesity and hypertension triggers a sympathetic activation and an impairment in baroreflex cardiovascular control that are greater in magnitude than those found in either of the above-mentioned abnormal conditions alone.
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Elevation in subcutaneous adiposity does not alter the baroreflex.
“elevation in subcutaneous adiposity does not alter the baroreflex.”
From Rapid Onset of Renal Sympathetic Nerve Activation in Rabbits Fed a High-Fat Diet (2012) · cites this paper as [31]
In humans with significant visceral adiposity, obesity hypertension is characterized by a reduction in baroreceptor inhibition.
“The hypertension in obesity is characterized by a reduction in baroreceptor inhibition in humans 31 when there is significant visceral adiposity”
From Rapid Onset of Renal Sympathetic Nerve Activation in Rabbits Fed a High-Fat Diet (2012) · cites this paper as [31]
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Rapid Onset of Renal Sympathetic Nerve Activation in Rabbits Fed a High-Fat Diet
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Recent insights into the interactions between the baroreflex and the kidneys in hypertension
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Influence of Prolonged Baroreflex Activation on Arterial Pressure in Angiotensin Hypertension
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Sympathetic nervous system as a target for aging and obesity-related cardiovascular diseases
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Impact of the obesity epidemic on hypertension and renal disease
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Effects of Hypertension and Obesity on the Sympathetic Activation of Heart Failure Patients
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Altered Renal Handling of Sodium in Human Hypertension
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Sustained Activation of the Central Baroreceptor Pathway in Angiotensin Hypertension
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Modest weight gain is associated with sympathetic neural activation in nonobese humans
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Counteracting the sympathetic nervous system in essential hypertension
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Self-citationNew developments in the pathogenesis of obesity-induced hypertension
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Heart Rate, Sympathetic Cardiovascular Influences, and The Metabolic Syndrome
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Leptin Impairs Cardiovagal Baroreflex Function at the Level of the Solitary Tract Nucleus
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Device-Based Neuromodulation for Resistant Hypertension Therapy
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- Authors
- Grassi, G., Seravalle, G., Dell’Oro, R., Turri, C., Bolla, G. B., & Mancia, G.
- Affiliations
- IRCCS Istituto Auxologico Italiano (IT)
- Venue
- Hypertension
- Published
- 2000-10
- Volume
- 36
- Issue
- 4
- Pages
- 538-542
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W1979098009
- Cited by
- 305
- References
- 39
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 11 · 2023: 8 · 2022: 5 · 2021: 10 · 2020: 5 · 2019: 14 · 2018: 5 · 2017: 13 · 2016: 14 · 2015: 16 · 2014: 17 · 2013: 22 · 2012: 14
- FWCI
- 6.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- obesity, obesity-related hypertension, baroreflex sensitivity, sympathetic nervous system, muscle sympathetic nerve activity, heart rate, baroreceptor stimulation, phenylephrine, sodium nitroprusside, cardiovascular regulation
- MeSH terms
- Adrenergic Fibers, Adult, Blood Pressure, Electrocardiography, Electrophysiology, Female, Heart Rate, Humans, Hypertension, Infusions, Intravenous, Male, Middle Aged, Nitroprusside, Obesity, Phenylephrine, Pressoreceptors, Thinness, Baroreflex, Sympathetic Fibers, Postganglionic
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