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Autonomic Dysfunction in Hypertension

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Autonomic Disorders in Clinical Practice

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Abstract

Autonomic dysfunction plays a key role in the development and progression of hypertension. Sustained impairment in autonomic cardiovascular modulation and the associated adrenergic overdrive to the heart, the kidneys and the peripheral vessels lead to haemodynamic and cardiometabolic alterations, which in turn contribute to elevation of blood pressure (BP) levels. If sustained over time, these alterations promote development of hypertension and hypertension-mediated organ damage (HMOD), ultimately leading to an increased risk of cardiovascular events and mortality. In its first part, this chapter will review the main techniques for evaluating autonomic cardiovascular modulation in hypertension, the role of autonomic dysfunction in favouring the development and progression of hypertension, and the mechanisms by which autonomic dysfunction promotes BP elevation. In its second part, focus will be put on the impact of autonomic dysfunction on HMOD and cardiovascular prognosis. The effects of hypertension treatment, either with pharmacological or device-based strategies aimed at improving autonomic function, on BP values and on cardiovascular prognosis will also be addressed.

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Authors and Affiliations

  1. Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy

    Gianfranco Parati & Juan Eugenio Ochoa

  2. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

    Gianfranco Parati

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  1. Gianfranco Parati
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  2. Juan Eugenio Ochoa
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Correspondence to Gianfranco Parati .

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Editors and Affiliations

  1. Emergency Neurology, Fondazione Istituto Neurologico Nazionale Mondino, Pavia, Italy

    Giuseppe Micieli

  2. Dept. of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany

    Max Hilz

  3. Neurology, Operative Director IRCCS ISNB, University of Bologna, Bologna, Italy

    Pietro Cortelli

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Parati, G., Ochoa, J.E. (2023). Autonomic Dysfunction in Hypertension. In: Micieli, G., Hilz, M., Cortelli, P. (eds) Autonomic Disorders in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-43036-7_3

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