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The Sympathetic Nervous System in Hypertension

  • Gino Seravalle
  • Giuseppe Mancia
  • Guido Grassi
Chapter
Part of the Contemporary Endocrinology book series (COE)

Abstract

It has been clearly shown that adrenergic tone has a primary role in blood pressure control due to the regulatory effects on cardiac output and systemic vascular resistance. Several mechanisms, both at central and peripheral levels, participate in this control exerted by the sympathetic nervous system. This chapter will review the main mechanisms involved starting from the new evidences from genetic studies. The effects of the sympathetic nervous system on the hypertensive state will be also evaluated in the different conditions starting from prehypertension to the resistant hypertensive state and the main secondary forms of hypertension.

Keywords

Sympathetic nervous system Arterial hypertension Prehypertension Dipping profile White-coat effect Secondary hypertension Resistant hypertension 

References

  1. 1.
    Guyenet PG. The sympathetic control of blood pressure. Nat Rev Neurosci. 2006;7:335–46.CrossRefGoogle Scholar
  2. 2.
    Dampney RA, Coleman MJ, Fontes MA, Hirooka Y, Horluchi J, Li YW, McAllen RM. Central mechanisms underlying short- and long-term regulation of the cardiovascular system. Clin Exp Pharmacol Physiol. 2002;29:261–8.CrossRefGoogle Scholar
  3. 3.
    Grassi G, Seravalle G. Sympatho-vagal imbalance in hypertension. In: Robertson D, Biaggioni I, Low PA, Paton JFR, editors. Primer on the autonomic nervous system. London: Academic Press; 2012. p. 345–8.CrossRefGoogle Scholar
  4. 4.
    Grassi G, Seravalle G, Dell’Oro R, Turri C, Pasqualinotto L, Colombo M, Mancia G. Participation of the hypothalamus-hypophysis axis in the sympathetic activation of human obesity. Hypertension. 2001;38:1316–20.CrossRefGoogle Scholar
  5. 5.
    Johns EJ, Kopp UC, DiBona GF. Neural control of renal function. Compr Physiol. 2011;1:731–67.PubMedGoogle Scholar
  6. 6.
    Iliescu R, Irwin ED, Georgakopoulos D, Lohmeier TE. Renal responses to chronic suppression of central sympathetic outflow. Hypertension. 2012;60:749–56.CrossRefGoogle Scholar
  7. 7.
    Mancia G. The sympathetic nervous system in hypertension. J Hypertens. 1997;15:1553–65.CrossRefGoogle Scholar
  8. 8.
    Lohmeier TE, Iliescu R. The baroreflex as a long-term controller of arterial pressure. Physiology. 2015;30:148–58.CrossRefGoogle Scholar
  9. 9.
    Grassi G, Mancia G. Hyperadrenergic and labile hypertension. In: Lip GH, Hall J, editors. Comprehensive hypertension. Philadelphia: Mosby Elsevier; 2007. p. 719–26.CrossRefGoogle Scholar
  10. 10.
    Yamada Y, Miyajima E, Tochikubo O, Matsukawa T, Shionoiri H, Ishii M, Kaneko Y. Impaired baroreflex changes in muscle sympathetic nerve activity in adolescents who have a family history of essential hypertension. J Hypertens. 1988;6:S525–8.CrossRefGoogle Scholar
  11. 11.
    Greenfield JR, Miller JW, Keogh JM, Henning E, Satterwhite JH, Cameron GS, Atruc B, Mayer JP, Brage S, See TC, Lomas DJ, O’Rahilly S, Farooqi IS. Modulation of blood pressure by central melanocortinergic pathways. N Engl J Med. 2009;360:44–52.CrossRefGoogle Scholar
  12. 12.
    Beets N, Harrison MD, Brede M, Zong X, Urbanski MJ, Sietmann A, Kaufling J, Barrot M, Seeliger MW, Vieira-Coelho MA, Hamet P, Gaudet D, Seda O, Tremblay J, Kotchen TA, Kaldunski M, Nusing R, Szabo B, Jacob HJ, Cowley AW Jr, Biel M, Stoll M, Lohse MJ, Broeckel U, Hein L. Phosducin influences sympathetic activity and prevents stress-induced hypertension in humans and mice. J Clin Invest. 2009;119:3597–612.Google Scholar
  13. 13.
    Grassi G. Phosducin – a candidate gene for stress-dependent hypertension. J Clin Invest. 2009;119:3515–8.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Grassi G, Padmanabhan S, Menna C, Seravalle G, Lee WK, Bombelli M, Brambilla G, Quarti Trevano F, Giannattasio C, Cesana G, Dominiczak A, Mancia G. Association between ADRA-1A gene and the metabolic syndrome: candidate genes and functional counterpart in the PAMELA population. J Hypertens. 2011;29:1121–7.CrossRefGoogle Scholar
  15. 15.
    Julius S, Krause L, Schork NJ, Mejia AD, Jones KA, van de Ven C, Johnson EH, Sekkarie MA, Kjeldsen SE, Petrin J. Hyperkinetic borderline hypertension in Tecumseh, Michigan. J Hypertens. 1991;9:77–84.CrossRefGoogle Scholar
  16. 16.
    Anderson EA, Sinkey CA, Lawton WJ, Mark AL. Elevated sympathetic nerve activity in borderline hypertensive humans. Evidences from direct intraneural recordings. Hypertension. 1989;14:177–83.CrossRefGoogle Scholar
  17. 17.
    Floras JS, Hara K. Sympathoneural and haemodynamic characteristics of young subjects with mild essential hypertension. J Hypertens. 1993;11:647–55.CrossRefGoogle Scholar
  18. 18.
    Esler M, Lambert G, Jennings G. Regional norepinephrine turnover in human hypertension. Clin Exp Hypertens. 1989;11(suppl 1):75–89.Google Scholar
  19. 19.
    Seravalle G, Lonati L, Buzzi S, Cairo M, Quarti Trevano F, Dell’Oro R, Facchetti R, Mancia G, Grassi G. Sympathetic nerve traffic and baroreflex function in optimal, normal, and high-normal blood pressure states. J Hypertens. 2015;33:1411–7.CrossRefGoogle Scholar
  20. 20.
    Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. ESH/ESC guidelines for the management of hypertension. J Hypertens. 2013;31:1281–357.CrossRefGoogle Scholar
  21. 21.
    Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ, Kannel WB, Levy D. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med. 2001;345:1291–7.CrossRefGoogle Scholar
  22. 22.
    Berne C, Fagius J, Pollare T, Hjemdahl P. The sympathetic response to euglycemic hyperinsulinemia. Evidence from microelectrode recordings in healthy subjects. Diabetologia. 1992;35:873–9.CrossRefGoogle Scholar
  23. 23.
    Vollenweider P, Randin D, Tappy L, Jequier E, Nicod P, Scherrer U. Impaired insulin-induced sympathetic neural activation and vasodilation in skeletal muscle in obese humans. J Clin Invest. 1994;93:2365–71.CrossRefGoogle Scholar
  24. 24.
    Goldstein DS. Plasma catecholamines and essential hypertension. An analytical review. Hypertension. 1983;5:86–99.CrossRefGoogle Scholar
  25. 25.
    Grassi G, Cattaneo BM, Seravalle G, Lanfranchi A, Mancia G. Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension. 1998;31:68–72.CrossRefGoogle Scholar
  26. 26.
    Sanders JS, Ferguson DW. Diastolic pressure determines autonomic responses to pressure perturbation in humans. J Appl Physiol. 1989;66:800–7.CrossRefGoogle Scholar
  27. 27.
    Grassi G, Seravalle G, Bertinieri G, Turri C, Dell’Oro R, Stella ML, Mancia G. Sympathetic and reflex alterations in systo-diastolic and systolic hypertension of the elderly. J Hypertens. 2000;18:587–93.CrossRefGoogle Scholar
  28. 28.
    Zimmerman BG. Evaluation of peripheral and central components of action of angiotensin on the sympathetic nervous system. J Pharmacol Exp Ther. 1967;158:1–10.PubMedGoogle Scholar
  29. 29.
    Reaven GM, Lithell H, Landsberg L. Hypertension and associated metabolic abnormalities – the role of insulin resistance and the sympathoadrenal system. N Engl J Med. 1996;334:374–81.CrossRefGoogle Scholar
  30. 30.
    Mark AL, Mancia G. Cardiopulmonary baroreflexes in humans. In: Shepherd JT, Abboud FM, editors. Handbook of physiology, section 2: the cardiovascular system. Bethesda: American Physiological Society; 1983. p. 795–813.Google Scholar
  31. 31.
    Crane MG, Harris JJ. Effect of ageing on renin activity and aldosterone excretion. J Lab Clin Med. 1976;87:947–59.PubMedGoogle Scholar
  32. 32.
    Grassi G, Vailati S, Bertinieri G, Seravalle G, Stella ML, Dell’Oro R, Mancia G. Heart rate as a marker of sympathetic activity. J Hypertens. 1998;16:1635–9.CrossRefGoogle Scholar
  33. 33.
    O’Brien E, Asmar R, Beilin L, Imai Y, Mallion JM, Mancia G, Mengden T, Myers M, Padfield P, Palatini P, Parati G, Pickering T, Redon J, Staessen J, Stergiou G, Verdecchia P, European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens. 2003;21:821–48.CrossRefGoogle Scholar
  34. 34.
    Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Gattobigio R, Guerrieri M, Comparato E, Benemio G, Porcellati C. Altered circadian blood pressure profile and prognosis. Blood Press Monit. 1997;2:347–52.PubMedGoogle Scholar
  35. 35.
    Ohkubo T, Imai Y, Tsuji I, Nagai K, Watanabe N, Minami N, Kato J, Kikuchi N, Nishiyama A, Aihara A, Sekino M, Satoh H, Hisamichi S. Relation between nocturnal decline in blood pressure and mortality. The Ohasama study. Am J Hypertens. 1997;10:1201–7.CrossRefGoogle Scholar
  36. 36.
    Grassi G, Seravalle G, Quarti Trevano F, Dell’Oro R, Bombelli M, Cuspidi C, Facchetti R, Bolla GB, Mancia G. Adrenergic, metabolic, and reflex abnormalities in reverse and extreme dipper hypertensives. Hypertension. 2008;52:925–31.CrossRefGoogle Scholar
  37. 37.
    Vyssoulis GP, Karpanou EA, Kyvelou SM, Adamopoulos DN, Deligeorgis AD, Spanos PG, Pietri PG, Cokkinos DF, Stefanadis CI. Nocturnal blood pressure fall and metabolic syndrome score in hypertensive patients. Blood Press Monit. 2007;12:351–6.CrossRefGoogle Scholar
  38. 38.
    Brasil RR, Soares DV, Spina LD, Lobo PM, da Silva EM, Mansur VA, Pinheiro MF, Coceicao FL, Vaisman M. Association of insulin resistance and nocturnal fall of blood pressure in GH-deficient adults during GH replacement. J Endocrinol Investig. 2007;30:306–12.CrossRefGoogle Scholar
  39. 39.
    Mancia G, Grassi G, Giannattasio C, Seravalle G. Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension. 1999;34:724–8.CrossRefGoogle Scholar
  40. 40.
    Cuspidi C, Macca G, Sampieri L, Fusi V, Severgnini B, Michev I, Salerno M, Magrini F, Zanchetti A. Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients. J Hypertens. 2001;19:1539–45.CrossRefGoogle Scholar
  41. 41.
    Mancia G, Bertinieri G, Grassi G, Parati G, Pomidossi G, Ferrari A, Gregorini L, Zanchetti A. Effects of blood pressure measurements by the doctor on patient’s blood pressure and heart rate. Lancet. 1983;II:695–8.CrossRefGoogle Scholar
  42. 42.
    Pierdomenico SD, Bucci A, Costantini F, Lapenna D, Cuccurullo F, Mezzetti A. Twenty-four hour autonomic nervous function in sustained and “white-coat” hypertension. Am Heart J. 2000;140:672–7.CrossRefGoogle Scholar
  43. 43.
    Grassi G, Turri C, Vailati S, Dell’Oro R, Mancia G. Muscle and skin sympathetic nerve traffic during “white-coat” effect. Circulation. 1999;100:222–5.CrossRefGoogle Scholar
  44. 44.
    Grassi G, Seravalle G, Quarti Trevano F, Dell’Oro R, Bolla GB, Cuspidi C, Arenare F, Mancia G. Neurogenic abnormalities in masked hypertension. Hypertension. 2007;50:537–42.CrossRefGoogle Scholar
  45. 45.
    Brod J, Fenci V, Hejl Z, Jirka J. Circulatory changes underlying blood pressure elevation during acute emotional stress in normotensive and hypertensive subjects. Clin Sci. 1959;18:269–79.PubMedGoogle Scholar
  46. 46.
    Mancia G, Facchetti R, Bombelli M, Grassi G, Sega R. Long-term risk of mortality associated with selective and combined elevation in office, home and ambulatory blood pressure. Hypertension. 2006;47:846–53.CrossRefGoogle Scholar
  47. 47.
    Ohkubo T, Kikuya M, Metoki H, Asayama K, Obara T, Hashimoto J, Totsune K, Hoshi H, Satoh H, Imai Y. Prognosis of “masked” hypertension and “white-coat” hypertension detected by 24-hour ambulatory blood pressure monitoring. 10 year follow-up from the Ohasama study. J Am Coll Cardiol. 2005;46:508–15.CrossRefGoogle Scholar
  48. 48.
    Miyajima E, Yamada Y, Yoshida Y, Matsukawa T, Shionoiri H, Tochikubo O, Ishii M. Muscle sympathetic nerve activity in renovascular hypertension and primary aldosteronism. Hypertension. 1991;17:1057–62.CrossRefGoogle Scholar
  49. 49.
    Grassi G, Seravalle G, Turri C, Mancia G. Sympathetic nerve traffic responses to surgical removal of pheochromocytoma. Hypertension. 1999;34:461–5.CrossRefGoogle Scholar
  50. 50.
    Converse RL Jr, Jacobsen TN, Toto RD, Jost CMT, Cosentino F, Fouad-Tarazi F, Victor R. Sympathetic overactivity in patients with chronic renal failure. N Engl J Med. 1992;327:1912–8.CrossRefGoogle Scholar
  51. 51.
    Grassi G, Quarti-Trevano F, Seravalle G, Arenare F, Volpe M, Furiani S, Dell’Oro R, Mancia G. Early sympathetic activation in the initial clinical stages of chronic renal failure. Hypertension. 2011;57:846–51.CrossRefGoogle Scholar
  52. 52.
    Hering D, Zdrojewski Z, Krol E, Kara T, Kucharska W, Somers V, Rutkowski B, Narkiewicz K. Tonic chemoreflex activation contributes to the elevated muscle sympathetic nerve activity in patients with chronic renal failure. J Hypertens. 2007;25:157–61.CrossRefGoogle Scholar
  53. 53.
    Mancia G, Dell’Oro R, Quarti Trevano F, Scopelliti F, Grassi G. Angiotensin-sympathetic system intercations in cardiovascular and metabolic disease. J Hypertens. 2006;24:51–6.CrossRefGoogle Scholar
  54. 54.
    Zoccali C. The endothelium as a target in renal diseases. J Nephrol. 2007;20:S39–44.PubMedGoogle Scholar
  55. 55.
    Schlaich MP, Sobotka PA, Krum H, Lambert E, Esler MD. Renal sympathetic nerve ablation for uncontrolled hypertension. N Engl J Med. 2009;361:932–4.CrossRefGoogle Scholar
  56. 56.
    Grassi G, Seravalle G, Brambilla G, Pini C, Alimento M, Facchetti R, Spaziani D, Cuspidi C, Mancia G. Marked sympathetic activation and baroreflex dysfunction in true resistant hypertension. Int J Cardiol. 2014;177:1020–5.CrossRefGoogle Scholar
  57. 57.
    Gaddam KK, Nishizaka MK, Pratt-Ubunama MN, Pimenta E, Aban I, Oparil S, Calhoun DA. Characterization of resistant hypertension: association between resistant hypertension, aldosterone, and persistent intravascular volume expansion. Arch Intern Med. 2008;168:1159–64.CrossRefGoogle Scholar
  58. 58.
    Narkiewicz K, van de Borne PJ, Cooley RL, Dyken ME, Somers VK. Sympathetic activity in obese subjects with and without sleep apnea. Circulation. 1998;98:772–6.CrossRefGoogle Scholar
  59. 59.
    Grassi G, Facchini A, Quarti Trevano F, Dell’Oro R, Arenare F, Tana F, Bolla G, Monzani A, Robuschi M, Mancia G. Obstructive sleep apnea-dependent and –independent adrenergic activation in obesity. Hypertension. 2005;46:321–5.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Gino Seravalle
    • 1
  • Giuseppe Mancia
    • 2
  • Guido Grassi
    • 3
    • 4
  1. 1.Cardiologia, Ospedale San Luca, IRCCS Istituto Auxologico ItalianoMilanItaly
  2. 2.Università Milano BicoccaMonzaItaly
  3. 3.Clinica Medica, Università Milano-Bicocca, Monza, and IRCCS MultimedicaSesto San Giovanni/MilanItaly
  4. 4.Clinica Medica, Ospedale S. Gerardo dei TintoriMonzaItaly

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