The Sympathetic Nervous System in Hypertension

Abstract

The sympathetic nervous system plays a central role in cardiovascular regulation in both health and disease. Sympathetic activation may be implicated in the pathogenesis of hypertension, coronary artery disease, cardiac arrhythmias and heart failure. This review focuses on sympathetic neural mechanisms in hypertension. We will review first, methods for studying sympathetic activity in humans; second, the cardiovascular ef fects of sympathetic activation; third, the evidence for sympathetic overactivity in hypertension; fourth, the nęural mechanisms enhancing sympathetic drive in hypertension; and fifth, the importance of humoral and metabolic mechanisms in sympathetic activation. While fundamental concepts outlined in earlier reviews [l, 2] will be revisited, emphasis will be placed on more recent developments.