The role of cardiac autonomic function in hypertension and cardiovascular disease

  title={The role of cardiac autonomic function in hypertension and cardiovascular disease},
  author={Paolo Palatini and Stevo Julius},
  journal={Current Hypertension Reports},
Autonomic nervous system abnormality, clinically manifested as a hyperkinetic circulation characterized by elevations in heart rate, blood pressure, plasma norepinephrine levels, and cardiac output, has been repeatedly demonstrated in hypertension. Increased release of norepinephrine from the brain has also been described in hypertension, and increased sympathetic activity has been demonstrated using spectral analysis of heart rate variability, particularly in the early stage of hypertension… 

Systemic Hemodynamics in Hypertension

The data from the literature indicate that sympathetic predominance starts early in life and is present in a sizable portion of the hypertensive population, which strongly suggest that the stimuli for the altered hemodynamic state in the early stage of hypertension emanate from the medulla oblongata.

The Autonomic Nervous System and Hypertension

The recent literature on the adrenergic and vagal abnormalities that have been reported in essential hypertension are reviewed, with emphasis on their role as promoters and as amplifiers of the high blood pressure state.

Autonomic modulation in hypertension without hypertrophy

Sympathetic tone begins to increase in hypertension before LVH develops, however, the impact of this increase on HRT is not clear and there is a need for further research to investigate the impact.

Arterial stiffness and the sympathetic nervous system

Evidence is available that sympathetic activity plays a major role in modulating the mechanical properties of muscular arteries, which explains the reduction in distensibility of muscular artery shown under particular conditions of stress.

Mancia and Grassi Autonomic Nervous System and Hypertension

This review describes the alterations in autonomic cardiovascular control that characterize human hypertension and discusses the possible mechanisms underlying these alterations and the evidence that they contribute to the functional and structural changes of the heart and systemic circulation that accompany a chronic hypertensive state and lead to its clinical complications.

Autonomic dysfunction in essential hypertension: A systematic review

  • E. Carthy
  • Medicine, Biology
    Annals of medicine and surgery
  • 2014

Hypertension Does Not Alter the Increase in Cardiac Baroreflex Sensitivity Caused by Moderate Cold Exposure

Untreated hypertension does not disturb cardiovascular protective mechanisms during moderate cold exposure commonly occurring in everyday life, and blunt response of the estimate of peripheral sympathetic modulation may indicate higher tonic sympathetic activity and decreased sympathetic responsiveness to cold in hypertension.

Autonomic and hemodynamic origins of pre-hypertension: central role of heredity.

Arterial hypertension in migraine: Role of familial history and cardiovascular phenotype




The sympathetic system and hypertension.

  • M. Esler
  • Medicine, Biology
    American journal of hypertension
  • 2000

Sympathetic activation in the pathogenesis of hypertension and progression of organ damage.

Evidence is reviewed by examining data showing that plasma norepinephrine is increased in essential hypertension and that this is also the case for systemic and regional norpinephrine spillover, as well as for the sympathetic nerve firing rate in the skeletal muscle nerve district.

Newer thinking on the hemodynamics of hypertension

Recent studies in subjects with borderline hypertension have shown that if the subjects were aware of having hypertension, they showed higher blood pressure and higher reactivity to mental stress and cold-pressor tests than uninformed subjects with similar blood pressures.

Role of the sympathetic nervous system in human hypertension

  • G. Grassi
  • Medicine, Biology
    Journal of hypertension
  • 1998
Findings explain why non-pharmacological and pharmacological approaches to the treatment of hypertension should be aimed not only at lowering elevated blood pressure values but also at exerting sympathoinhibitory effects.

Autonomic nervous system activity in normotensive subjects with a family history of hypertension

The results indicate that even normotensives with a family history of hypertension exhibit an increased ratio of sympathetic to parasympathetic activity at the cardiac level; however, they do not show any alteration of the vascular sympathetic reactivity.

Evolution of blood pressure and cholesterol in stage 1 hypertension: role of autonomic nervous system activity

Data indicate that a condition characterized by sympathetic predominance may favour the development of sustained hypertension and hypercholesterolemia early in life, and lead to increased susceptibility to vascular complications, and indicate that the increased white-coat effect is not an innocent phenomenon.

Sympathetic activity, assessed by power spectral analysis of heart rate variability, in white-coat, masked and sustained hypertension versus true normotension

The findings at rest are compatible with increased sympathetic activity and decreased parasympathetic modulation in white-coat hypertension, with normal autonomic cardiac regulation in masked and sustained hypertension.

Noradrenaline spillover and microneurography measurements in patients with primary hypertension.

  • G. Jennings
  • Biology, Medicine
    Journal of hypertension. Supplement : official journal of the International Society of Hypertension
  • 1998
Quantification of sympathetic nervous activity is important in hypertension as the sympathetic system may play both long-term and short-term roles in cardiovascular regulation; it may be involved in