Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension.

  title={Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension.},
  author={Murray Esler and Elisabeth A. Lambert and Markus P. Schlaich},
  journal={Journal of applied physiology},
  volume={109 6},
          1996-8; discussion 2016
For the past three decades, the renin-angiotensin system has been the major focus in high blood pressure research. The proven value of antihypertensive drugs that block this system has deflected research from other blood pressure-raising systems, including the sympathetic nervous system. Despite 

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Last Word on Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension

to the editor: I thank my friends, colleagues, and opponents for their thoughtful submissions (see Ref. [1][1]), which capture the diversity of views concerning the pathophysiological mechanisms of

Counterpoint: Activation of the intrarenal renin-angiotensin system is the dominant contributor to systemic hypertension.

The dominant mechanism responsible for hypertension calls to mind the famous poem, “The Blind Men and the Elephant,” by John Godfrey Saxe based on an ancient fable from India, which described the elephant based on their specific encounter.

The sympathetic nervous system and blood pressure in humans: implications for hypertension

A perspective on the actions and interactions of angiotensin II, inflammation and vascular dysfunction/brain hypoperfusion in the pathogenesis and progression of neurogenic hypertension is provided.

Pathophysiology of Renal Sympathetic Denervation (RSDN)

Activation of the sympathetic nervous system (SNS) has been identified as a key pathophysiological feature involved in the initiation, progression but also prognosis of most cardiometabolic disorders

Renal denervation for resistant hypertension.

  • M. AlmeidaP. GonçalvesE. OliveiraH. Carvalho
  • Medicine, Biology
    Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
  • 2015

The Causal Role of Chronic Mental Stress in the Pathogenesis of Essential Hypertension

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Comments on Point:Counterpoint: The dominant contributor to systemic hypertension: Chronic activation of the sympathetic nervous system vs. Activation of the intrarenal renin-angiotensin system

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Analysis of potential mechanisms underlying sympathetic activation in chronic kidney disease, the range of adverse consequences associated with this activation, and potential therapeutic implications resulting from this relationship are analyzed.

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A selective increase in the sympathetic nervous outflow to the heart and kidneys is commonly present in young patients with primary hypertension, and probably contributes materially to the early pathogenesis of the hypertension.

Sympathetic Augmentation in Hypertension: Role of Nerve Firing, Norepinephrine Reuptake, and Angiotensin Neuromodulation

Increased rates of sympathetic nerve firing and reduced neuronal NE reuptake both contribute to sympathetic activation in hypertension, whereas a role for dampened arterial baroreflex restraint on sympathetic nerve traffic and a peripheral neuromodulating influence of angiotensin II appear to be excluded.

Propranolol inhibition of renin secretion. A specific approach to diagnosis and treatment of renin-dependent hypertensive diseases.

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Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension

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