Reversible Sympathetic Overactivity in Hypertensive Patients with Primary Aldosteronism
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CONTEXT: Aldosterone has been shown to exert a central sympathoexcitatory action in multiple animal models, but evidence in humans is still lacking. OBJECTIVES: Our objective was to determine whether hyperaldosteronism causes reversible sympathetic activation in humans. METHODS: We performed a cross-sectional comparison of muscle sympathetic nerve activity (SNA, intraneural microelectrodes) in 14 hypertensive patients with biochemically proven primary aldosteronism (PA) with 20 patients with essential hypertension (EH) and 18 age-matched normotensive (NT) controls. Seven patients with aldosterone-producing adenoma (APA) were restudied 1 month after unilateral adrenalectomy. RESULTS: Mean blood pressure values in patients with PA and EH and NT controls was 145 ± 4/88 ± 2, 150 ± 4/90 ± 2, and 119 ± 2/76 ± 2 mm Hg, respectively. The major new findings are 2-fold: 1) baseline SNA was significantly higher in the PA than the NT group (40 ± 3 vs. 30 ± 2 bursts/min, P = 0.014) but similar to the EH group (41 ± 3 bursts/min) and 2) after unilateral adrenalectomy for APA, SNA decreased significantly from 38 ± 5 to 27 ± 4 bursts/min (P = 0.01), plasma aldosterone levels fell from 72.4 ± 20.3 to 11.4 ± 2.3 ng/dl (P < 0.01), and blood pressure decreased from 155 ± 8/94 ± 3 to 117 ± 4/77 ± 2 mm Hg (P < 0.01). CONCLUSION: These data provide the first evidence in humans that APA is accompanied by reversible sympathetic overactivity, which may contribute to the accelerated hypertensive target organ disease in this condition.
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Some studies have reported that patients with hypertension secondary to renal artery stenosis or primary aldosteronism display an increase in sympathetic nerve traffic to skeletal muscle circulation.
“Some studies have reported that patients with hypertension secondary to renal artery stenosis or primary aldosteronism also display an increase in sympathetic nerve traffic to skeletal muscle circulation54–56.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [56]
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References 36 · Cited by 71
Research works printed but not linked: 1
- [28]28. **Felder RB** 2010 Mineralocorticoid receptors, inflammation and sympathetic drive in heart failure. Exp Physiol 95:19–23 [[DOI](https://doi.org/10.1113/expphysiol.2008.045948)] [[PMC free article](/articles/PMC2917189/)] [[PubMed](https://pubmed.ncbi.nlm.nih.gov/19648480/)] [[Google Scholar](https://scholar.google.com/scholar_lookup?Felder%20RB%202010%20Mineralocorticoid%20receptors,%20inflammation%20and%20sympathetic%20drive%20in%20heart%20failure.%20Exp%20Physiol%2095:19%E2%80%9323)] · DOI
- Authors
- Kontak, A. C., Wang, Z., Arbique, D., Adams-Huet, B., Auchus, R. J., Nesbitt, S. D., Victor, R. G., & Vongpatanasin, W.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Cedars-Sinai Medical Center (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2010-10
- Volume
- 95
- Issue
- 10
- Pages
- 4756-4761
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC3050103
- OpenAlex
- W1979939318
- Cited by
- 71
- References
- 36
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 8 · 2014: 6 · 2013: 6 · 2012: 7
- FWCI
- 5.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL-078782, R01HL078782)
- National Center for Research Resources (UL1RR024982)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- primary aldosteronism, aldosterone-producing adenoma, sympathetic nervous system, muscle sympathetic nerve activity, essential hypertension, adrenalectomy, hyperaldosteronism, blood pressure, target organ damage
- MeSH terms
- Adrenalectomy, Adult, Blood Pressure, Cross-Sectional Studies, Female, Humans, Hyperaldosteronism, Hypertension, Male, Middle Aged, Sympathetic Nervous System, Case-Control Studies
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