Grassi Guido, Bombelli Michele, Buzzi Silvia, Volpe Marco, Brambilla Gianmaria
1] Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Monza, Italy [2] IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Monza, Italy.
Hypertens Res. 2014 Jun;37(6):479-83. doi: 10.1038/hr.2014.25. Epub 2014 Feb 27.
Several studies have investigated the behavior of sympathetic cardiovascular drive in essential hypertension, providing conclusive evidence of the adrenergic activation characterizing this condition. These studies have also shown the importance of neuroadrenergic overdrive in the development and progression of the hypertensive state as well as in the pathogenesis of hypertension-related end-organ damage. The information available on the sympathetic nervous system's behavior in 'pseudo-resistant' and 'true resistant' hypertension is much more scarce. This paper will review the available knowledge on this issue by examining the data collected via indirect and direct approaches to investigate adrenergic function in resistant hypertension as well as the effects of pharmacological and non-pharmacological interventions.
多项研究调查了原发性高血压患者交感神经心血管驱动的行为,为这种疾病所特有的肾上腺素能激活提供了确凿证据。这些研究还表明,神经肾上腺素能过度驱动在高血压状态的发生和发展以及高血压相关终末器官损害的发病机制中具有重要意义。关于交感神经系统在“假性难治性”和“真性难治性”高血压中行为的现有信息则少得多。本文将通过审视通过间接和直接方法收集的数据来回顾关于这个问题的现有知识,这些数据用于研究难治性高血压中的肾上腺素能功能以及药理和非药理干预的效果。