Cardiology Letters 2015, 24(4):226-229

Role of sympathetic nervous system in the pathophysiology of resistant hypertension

Škultétyová D

Klinika kardiológie a angiológie, Národný ústav srdcových a cievnych chorôb, a.s., Bratislava, Slovenská republika

The pathogenesis of hypertension is complex and multifactorial. Increased sympathetic nervous system (SNS) activity has been documented in all hypertension stages, the more advanced the stage, the greater the adrenergic activity. The excessive SNS activity plays a crucial role in the development of resistant hypertension (RH). The autonomic NS can modulate innate and adaptive immunity and thereby influence the inflammatory response. The sympathoexcitation and the neuro-immune pathways may increase the initiation or acceleration of pathological processes. Obesity and salt sensitivity are important environmental risk factors in hypertension. Both factors are considered to play a major role in the brain and renal sympathoexcitation. Targeting the brain to reduce enhanced sympathetic activity should be considered in the treatment for hypertension. Novel techniques, such as catheter-based renal denervation and carotid baroreflex activation therapy, are suggested to reduce central and renal sympathetic otflow.

Keywords: autonomic nervous system; neuro-immune axis; inflammation; catheter-based renal denervation; carotid baroreflex activation therapy

Published: April 1, 2015  Show citation