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The role of the sympathetic nervous system in hypertension. Facts and Fallacies

journal contribution
posted on 1996-01-01, 00:00 authored by John Amerena, S Julius
Sympathetic overactivity is evident in young patients with mild hypertension who have tachycardia, elevated cardiac output, norepinephrine, renin and insulin levels. As hypertension advances, the cardiac sympathetic responsiveness decreases, whereas the vascular responsiveness increases. Eventually, the hemodynamic picture changes from a high cardiac output to a high vascular resistance. These changes becloud the more obvious signs of sympathetic overactivity, but the autonomic imbalance continues to contribute to the pathophysiology of hypertension and its complications. Increased sympathetic tone is involved in the association of hypertension with dyslipidemia, insulin resistance, high hematocrit, cardiovascular hypertrophy and vulnerability to arrhythmias. A better understanding of how sympathetic overactivity contributes to excess coronary risk in hypertension may lead to new treatment strategies to prevent coronary complications of hypertension.

History

Journal

Cardiology in Review

Volume

4

Issue

6

Pagination

340 - 352

ISSN

1061-5377

Publication classification

C1.1 Refereed article in a scholarly journal

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