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Current Hypertension Reports

, Volume 10, Issue 6, pp 440–447 | Cite as

Mediators of sympathetic activation in metabolic syndrome obesity

  • Nora E. StraznickyEmail author
  • Nina Eikelis
  • Elisabeth A. Lambert
  • Murray D. Esler
Article

Abstract

The metabolic syndrome represents a major public health burden because of its high prevalence in the general population and its association with cardiovascular disease and type 2 diabetes. Accumulated evidence based on biochemical, neurophysiologic, and indirect measurements of autonomic activity indicate that visceral obesity and the metabolic syndrome are associated with enhanced sympathetic neural drive and vagal impairment. The mechanisms linking metabolic syndrome with sympathetic activation are complex and not completely understood, and cause-effect relationships need further clarification from prospective trials. Components of the metabolic syndrome that may directly or indirectly enhance sympathetic drive include hyperinsulinemia, leptin, nonesterified fatty acids, proinflammatory cytokines, angiotensinogen, baroreflex impairment, and obstructive sleep apnea. β-Adrenoceptor polymorphisms have also been associated with adrenoceptor desensitization, increased adiposity, insulin resistance, and enhanced sympathetic activity. Because chronic sympathetic activation contributes to hypertension and its target-organ damage, sympatho-inhibition remains an important goal in the therapeutic management of the metabolic syndrome.

Keywords

Metabolic Syndrome Obstructive Sleep Apnea Heart Rate Variability Muscle Sympathetic Nerve Activity Continuous Positive Airway Pressure Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  • Nora E. Straznicky
    • 1
    Email author
  • Nina Eikelis
  • Elisabeth A. Lambert
  • Murray D. Esler
  1. 1.Human Neurotransmitters LaboratoryBaker IDI Heart and Diabetes InstituteMelbourneAustralia

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