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Cited by 194Heart Rate Variability and Autonomic ControlBlood Pressure and Hypertension StudiesCardiovascular Function and Risk Factors

Sympathetic and Baroreflex Cardiovascular Control in Hypertension-Related Left Ventricular Dysfunction

Grassi, Guido, Seravalle, Gino, Quarti-Trevano, Fosca, Dell'Oro, Raffaella, Arenare, Francesca, Spaziani, Domenico, Mancia, Giuseppe·2009·Hypertension
DOI 10.1161/hypertensionaha.108.121467
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Abstract

The sympathetic overdrive that characterizes essential hypertension is potentiated when left ventricular hypertrophy or congestive heart failure is detected. No information exists, however, on whether this is the case also for left ventricular diastolic dysfunction. In 17 untreated hypertensive subjects with left ventricular diastolic dysfunction (age: 47.7±2.9 years, mean±SEM), we measured sympathetic nerve traffic (microneurography), heart rate (ECG), and beat-to-beat arterial blood pressure (Finapres) at rest and during baroreceptor deactivation and stimulation. Data were compared with those collected in 20 age-matched normotensive and 20 hypertensive subjects without a diastolic function impairment. Muscle sympathetic nerve traffic values were markedly and significantly greater in the 2 hypertensive groups than in the normotensive one (55.3±1.2 and 71.2±1.6 versus 41.7±1.0 bursts per 100 heartbeats, respectively; P <0.01 for both). For a similar blood pressure elevation, however, the sympathetic nerve traffic increase was significantly greater in patients with than without left ventricular diastolic dysfunction (+28.9%; P <0.05). In the population as a whole, muscle sympathetic nerve traffic was significantly and inversely related to various echocardiographic indices of diastolic function. Although baroreflex-heart rate control was significantly attenuated in the 2 hypertensive groups, baroreflex-sympathetic modulation was impaired only in those with diastolic dysfunction. These data provide the first evidence that, in hypertension, activation of the sympathetic nervous system may contribute not only at the blood pressure elevation but also at the development of left ventricular diastolic dysfunction. The sympathetic overactivity, which is likely to be related to the baroreflex impairment, may account for the increased cardiovascular risk characterizing diastolic dysfunction.

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  • Adrenergic neural factors may contribute to the development and progression of target organ damage, as documented by pronounced increases in sympathetic nerve traffic and cardiac norepinephrine spillover rate in patients with hypertension complicated by left ventricular hypertrophy or left ventricular diastolic dysfunction.

    “Adrenergic neural factors may also contribute to the development and progression of target organ damage, as documented by the pronounced increase in sympathetic nerve traffic and cardiac norepinephrine spillover rate in patients in which hypertension is complicated by left ventricular hypertrophy or left ventricular diastolic dysfunction40,42,44,45.”

    From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [45]

  • 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 [45]

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Authors
Grassi, G., Seravalle, G., Quarti-Trevano, F., Dell'Oro, R., Arenare, F., Spaziani, D., & Mancia, G.
Affiliations
  • IRCCS Istituto Auxologico Italiano (IT)
  • From the Clinica Medica (G.G., F.Q-T., R.D., F.A., G.M.), Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo, Milan, Italy; Istituto Auxologico Italiano (G.G., G.S., G.M.), Milan, Italy; and the Divisione di Cardiologia (D.S.), Ospedale di Legnano, Legnano, Italy.
ORCID
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-02
Volume
53
Issue
2
Pages
205-209
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/hypertensionaha.108.121467
OpenAlex
W2122749049
Cited by
194
References
40
Citations by year
2026: 7 · 2025: 11 · 2024: 13 · 2023: 11 · 2022: 10 · 2021: 3 · 2020: 8 · 2019: 11 · 2018: 12 · 2017: 11 · 2016: 16 · 2015: 10 · 2014: 11 · 2013: 13 · 2012: 20
FWCI
10.18
Type
journal article
Language
en
Open access
closed
Locations
  • Hypertension (publishedVersion)
  • PubMed (publishedVersion)
  • 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
essential hypertension, left ventricular diastolic dysfunction, sympathetic nervous system, baroreflex, muscle sympathetic nerve activity, baroreflex sensitivity, rate control, cardiovascular risk, sympathetic hyperactivity
MeSH terms
Adult, Blood Pressure, Cardiac Output, Cardiovascular Physiological Phenomena, Heart Rate, Heart Ventricles, Humans, Hypertension, Male, Middle Aged, Stroke Volume, Sympathetic Nervous System, Echocardiography, Doppler, Case-Control Studies, Baroreflex, Ventricular Dysfunction, Left

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