Cardiovascular Center Frankfurt, Frankfurt, Germany.
JACC Cardiovasc Interv. 2012 Mar;5(3):249-58. doi: 10.1016/j.jcin.2011.12.011.
Systemic hypertension is a major burden to the individual and society. Its association with major adverse cardiac and cerebral events and favorable effects of antihypertensive therapy are undisputed. However, despite multidrug therapy, blood pressures are frequently suboptimally controlled. Moreover, adverse drug effects often interfere with patients' lifestyles and affect compliance. Therefore, alternative treatment strategies have been explored. Most recently, attention has been redirected to the sympathetic nervous system (SNS) in the pathogenesis of hypertension. In addition, interruption of the renal SNS in humans with resistant hypertension has been studied with promising results. The following review provides an overview of the anatomy and physiology of the renal SNS, the rational for manipulating the SNS, and the results of therapeutic renal sympathetic denervation.
系统性高血压是个人和社会的主要负担。它与主要的心脏和大脑不良事件的发生相关，并且降压治疗效果显著，这是无可争议的。然而，尽管采用了多种药物治疗，血压仍经常控制不佳。此外，药物的不良反应常常干扰患者的生活方式，影响其顺应性。因此，人们一直在探索替代治疗策略。最近，人们的注意力重新集中到了高血压发病机制中的交感神经系统 (SNS)。此外，人们还研究了通过中断难治性高血压患者的肾交感神经来治疗高血压，结果令人鼓舞。以下综述提供了肾 SNS 的解剖学和生理学概述、干预 SNS 的合理性以及治疗性肾交感神经切除术的结果。
