Role of the Nervous System in Human Hypertension

  • John Amerena
  • Stevo Julius
Part of the Atlas of Heart Diseases book series (AD)


Despite early demonstrations that sympathetic activation elevates blood pressure and early clinical inklings that human hypertension may have a psychosomatic component, the pivotal role of the nervous system in human hypertension is only recently being clarified. There are two reasons for this delayed appreciation of the role the autonomic nervous system plays in the genesis and maintenance of blood pressure elevation in hypertension. First are the complexities involved in the evaluation of the autonomic function in humans and second is that hypertension is a dynamic process in which the manifestations of autonomic overactivity change with time.


Cardiac Output Blood Pressure Response Sympathetic Tone Nucleus Tractus Solitarius Isometric Exercise 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Owsjannikow PH: Die tonische und reflectorische centren de gefassnervum. Verh K Sachs Ges Wisse 1871, 23: 134.Google Scholar
  2. 2.
    Loewy AD: Anatomy of the autonomic nervous system. In Central Regulation of Autonomic Functions. Edited by Loewy AD, Spyer KM. New York: Oxford University Press; 1990: 3–16.Google Scholar
  3. 3.
    Spyer KM: CNS organization of reflex circulatory control. In Central Regulation of Autonomic Functions. Edited by Loewy AD, Spyer KM. New York: Oxford University Press; 1990: 168–188.Google Scholar
  4. 4.
    Julius S, Pascual A, London R: Role of parasympathetic inhibition in the hyperkinetic type of borderline hypertension. Circulation 1971, 44: 413–418.PubMedCrossRefGoogle Scholar
  5. 5.
    Struyker Boudier HAJ: Adrenergic mechanisms and pharmacotherapy of hypertension. In Adrenergic Blood Pressure Regulation: Proceedings of a Symposium. Edited by Birkenhäger WH, Folkow B, Struyker Boudier HAJ. Amsterdam, The Netherlands: Excerpta Medica; 1985: 114–123.Google Scholar
  6. 6.
    Krief S, Lonnqvist F, Raimbaults, et al.: Tissue distribution of the ß-3 receptor m-RNA in man. / Clin Invest 1993, 91: 344–349.CrossRefGoogle Scholar
  7. 7.
    Linden ME, Gilman AG: G proteins. Sci Am 1992, 267: 56–91.CrossRefGoogle Scholar
  8. 8.
    Mancia G, Grasso G, Bertinieri G, et al.: Effects of blood pressure measurement by the doctor on the patient’s blood pressure and heart rate. Lancet 1983, 2: 695–698.PubMedCrossRefGoogle Scholar
  9. 9.
    Weder AB, Julius S: Behavior, blood pressure variability and hypertension. Psychosomatics 1985, 47: 406–414.Google Scholar
  10. 10.
    Osterziel KJ, Julius S, Brant D: Blood pressure elevation during hindquarter compression in dogs is neurogenic. J Hypertens 1984, 4: 411–417.Google Scholar
  11. 11.
    Julius S, Sanches R, Malayen S, et al.: Sustained blood pressure elevation to lower body compression in pigs and dogs. Hypertension 1982, 4: 782–788.PubMedCrossRefGoogle Scholar
  12. 12.
    Millar-Craig MW, Bishop CN, Raftery EB: Circadian variation of blood pressure. Lancet 1978, ii: 795–797.CrossRefGoogle Scholar
  13. 13.
    Bristow JD, Honour AJ, Pickering GW, et al.: Diminished baroreceptor sensitivity in high blood pressure. Circulation 1969, 39: 48–54.PubMedCrossRefGoogle Scholar
  14. 14.
    Korner PI, West MJ, Shaw J, et al.: “Steady state” properties of the baroreceptor-heart rate reflex in essential hypertension in man. Clin Exp Pharmacol Physiol 1974, 1: 65–76.PubMedCrossRefGoogle Scholar
  15. 15.
    Mancia G, Ludbrook J, Ferrari A, et al.: Baroreceptor reflexes in human hypertension. Circ Res 1978, 43: 170–177.PubMedCrossRefGoogle Scholar
  16. 16.
    Philipp TH, Distler A, Cordes U: Sympathetic nervous system and blood pressure control in essential hypertension. Lancet 1978, 2: 959–964.PubMedCrossRefGoogle Scholar
  17. 17.
    Egan BM, Panis R, Hinderliter A, et al.: Mechanism of increased α-adrenergic vasoconstriction in human hypertension. / Clin Invest 1987, 80: 812–817.CrossRefGoogle Scholar
  18. 18.
    Folkow B, Grumby G, Thulesius O: Adaptive structural changes of the vascular wall in hypertension and their relationship to control of the peripheral resistance. Acta Physiol Scand 1958, 44: 255.PubMedCrossRefGoogle Scholar
  19. 19.
    Korsgaard K, Aalkjaer C, Heagerty G, et al.: Histology of subcutaneous small arteries from patients with essential hypertension. Hypertension 1993, 22: 523–526.PubMedCrossRefGoogle Scholar
  20. 20.
    Wikstrand J: Cardiovascular function during long term antihypertensive adrenergic blockade. In Adrenergic Blood Pressure Regulation: Proceedings of a Symposium. Edited by Birkenhäger WH, Folkow B, Struyker Boudier HAJ. Amsterdam, The Netherlands: Excerpta Medica; 1985: 125–137.Google Scholar
  21. 21.
    Esler M, Jennings G, Lambert G: Noradrenaline release and the pathophysiology of primary human hypertension. Am J Hypertens 1989, 2: 140S–146S.PubMedGoogle Scholar
  22. 22.
    Esler M, Lambert G, Jennings G: Regional norepinephrine turnover in human hypertension. Clin Exp Theory Pract 1989, A11(suppl 1): 75–89.CrossRefGoogle Scholar
  23. 23.
    Lambert GW, Ferrier C, Kaye D, et al.: Central nervous system norephinephrine turnover in essential hypertension. Ann NY Acad Sci 1995, 763: 679–694.PubMedCrossRefGoogle Scholar
  24. 24.
    Esler M, Julius S, Zweifler A, et al.: Mild high renin essential hypertension: neurogenic human hypertension. N Engl J Med 1977, 296: 405–411.PubMedCrossRefGoogle Scholar
  25. 25.
    Anderson EA, Sinkey CA, Lawton WJ, Mark AL: Elevated sympathetic nerve activity in borderline hypertensive humans: evidence from direct intra-neural recordings. Hypertension 1989, 14: 177–183.PubMedCrossRefGoogle Scholar
  26. 26.
    Guzzetti S, Piccaluga E, Casati R, et al.: Sympathetic predominance in essential hypertension: a study employing spectral analysis of heart rate variability. J Hypertens 1988, 6: 711–717.PubMedCrossRefGoogle Scholar
  27. 27.
    Julius S, Jamerson K: Sympathetics, insulin resistance and coronary risk in hypertension: the chicken-and-egg question. J Hypertens 1994, 12: 495–502.PubMedCrossRefGoogle Scholar
  28. 28.
    Levy RL, White PD, Stroud WD, et al.: Transient tachycardia: prognostic significance alone and in association with transient hypertension. JAMA 1945, 129: 585–588.CrossRefGoogle Scholar
  29. 29.
    Julius S, Krause L, Schork N, et al.: Hyperkinetic borderline hypertension in Tecumseh, Michigan. J Hypertens 1991, 9: 77–84.PubMedGoogle Scholar
  30. 30.
    Julius S: Neurogenic component in borderline hypertension. In The Nervous System in Arterial Hypertension. Edited by Julius S, Esler MD. Springfield, IL: Charles C. Thomas; 1976: 301–330.Google Scholar
  31. 31.
    Julius S, Schork N, Johnson E, et al.: Independence of pressure reactivity from blood pressure levels in Tecumseh, Michigan. Hypertension 1991, 17: 13–19.CrossRefGoogle Scholar
  32. 32.
    Julius S, Pascual A, Sannerstedt R, et al.: Relationship between cardiac output and peripheral resistance in borderline hypertension. Circulation 1971, 43: 382–390.PubMedCrossRefGoogle Scholar
  33. 33.
    Sannerstedt R, Julius S: Systemic haemodynamics in borderline arterial hypertension: responses to static exercise before and under the influence of propranolol. Cardiovasc Res 1972, 6: 398–403.PubMedCrossRefGoogle Scholar
  34. 34.
    Hollenberg NK, Williams GH, Adams DF: Essential hypertension: abnormal renal vascular and endocrine responses to a mild psychological stimulus. Hypertension 1981, 3: 11–17.PubMedCrossRefGoogle Scholar
  35. 35.
    Noll G, Wenzel R, Schneider M, et al.: Increased activation of sympathetic nervous system and endothelin by mental stress in normotensive offspring of hypertensive parents. Circulation 1996, 93: 866–869.PubMedCrossRefGoogle Scholar
  36. 36.
    Böhm R, van Baak M, van Hooff M, et al.: Salivary flow in borderline hypertension. Klin Wochenschr 1985, 63: 154–156.PubMedGoogle Scholar
  37. 37.
    Harburg E, Julius S, McGinn NF, et al.: Personality traits and behavioral patterns associated with systolic blood pressure levels in college males. / Chronic Dis 1964, 17: 405–414.CrossRefGoogle Scholar
  38. 38.
    Esler M, Julius S, Zweifler A, et al.: Mild high-renin essential hypertension: neurogenic human hypertension? N Engl J Med 1977, 296: 405–411.PubMedCrossRefGoogle Scholar
  39. 39.
    Lund-Johansen P: Hemodynamic patterns of untreated hypertensive disease. In Hypertension: Pathophysiology, Diagnosis, and Management. Edited by Laragh JH, Brenner BM. New York: Raven Press; 1990: 305–327.Google Scholar
  40. 40.
    Lund-Johansen P: Central haemodynamics in essential hypertension at rest and during exercise: a 20-year follow-up study. J Hypertens 1989, 7(suppl 6): 52–55.Google Scholar
  41. 41.
    Julius S, Randall OS, Esler MD, et al.: Altered cardiac responsiveness and regulation in the normal cardiac output type of borderline hypertension. Circ Res 1975, 36-37(suppl I): 199–207.CrossRefGoogle Scholar
  42. 42.
    Ulrych M: Changes of general haemodynamics during stressful mental arithmetic and non-stressing quiet conversation and modification of the latter by ß-adrenergic blockade. Clin Sci 1969, 36: 453–461.PubMedGoogle Scholar
  43. 43.
    Baccelli G, Valentini R, Gregorini L, et al.: Haemodynamic effects of isometric handgrip exercise in patients convalescent from myocardial infarction. Clin Exp Pharmacol Physiol 1978, 5: 607–615.PubMedCrossRefGoogle Scholar
  44. 44.
    Julius S, Sanchez R, Brant D: Pressure increase to external hindquarter compression in dogs: a facultative regulatory response. J Hypertens 1986, 4(suppl 6): 54–56.Google Scholar
  45. 45.
    Julius S: Editorial review: the blood pressure seeking properties of the central nervous system. J Hypertens 1988, 6: 177–185.PubMedCrossRefGoogle Scholar
  46. 46.
    Julius S, Jamerson K, Mejia A, et al.: The association of borderline hypertension with target organ changes and higher coronary risk. Tecumseh Blood Pressure study. JAMA 1990, 264: 354–358.PubMedCrossRefGoogle Scholar
  47. 47.
    Palatini P, Julius S: Heart rate and the cardiovascular risk. J Hypertens 1997, 15: 3–17.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • John Amerena
  • Stevo Julius

There are no affiliations available

Personalised recommendations