Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Curr Pharm Des. 2018;24(2):130-139. doi: 10.2174/1381612823666171114170642.
A high dietary intake of polyphenols has been associated with a reduced cardiovascular mortality, due to their antioxidant properties. However, growing evidence suggests that counteracting oxidative stress in cardiovascular disease might also reduce sympathetic nervous system overactivity.
This article reviews the most commonly used techniques to measure sympathetic activity in humans; the role of sympathetic activation in the pathophysiology of cardiovascular diseases; current evidence demonstrating that oxidative stress is involved in the regulation of sympathetic activity and how antioxidants and polyphenols might counteract sympathetic overactivity, particularly focusing on preliminary data from human studies.
The main mechanisms by which polyphenols are cardioprotective are related to the improvement of vascular function and their anti-atherogenic effect. Furthermore, a blood pressure-lowering effect was consistently demonstrated in randomized controlled trials in humans, when the effect of flavonoid-rich foods, such as tea and chocolate, was tested. More recent studies suggest that inhibition of sympathetic overactivity might be one of the mechanisms by which these substances exert their cardioprotective effects. Indeed, an increased adrenergic traffic to the vasculature is a major mechanism of disease in a number of cardiovascular and extra-cardiac diseases, including hypertension, obesity, metabolic syndrome and heart failure. A considerable body of evidence, mostly from experimental studies, support the hypothesis that reactive oxygen species might exert sympathoexcitatory effects both at the central and at the peripheral level. Accordingly, supplementation with antioxidants might reduce adrenergic overdrive to the vasculature and blunt cardiovascular reactivity to stress.
While supplementation with "classical" antioxidants such as ROS-scavengers has many limitations, increasing the intake of polyphenol-rich foods seems to be a promising novel therapeutic strategy to reduce the deleterious effects of increased adrenergic tone, particularly in essential hypertension.
由于具有抗氧化特性，高多酚饮食摄入量与降低心血管死亡率有关。然而，越来越多的证据表明，在心血管疾病中对抗氧化应激也可能减少交感神经系统的过度活跃。
本文综述了目前常用的几种测量人类交感神经活性的技术；交感神经激活在心血管疾病病理生理学中的作用；目前的证据表明氧化应激参与了交感神经活性的调节，以及抗氧化剂和多酚如何对抗交感神经过度活跃，特别是特别关注来自人体研究的初步数据。
多酚具有心脏保护作用的主要机制与改善血管功能和抗动脉粥样硬化作用有关。此外，在对富含类黄酮的食物（如茶和巧克力）进行测试的随机对照试验中，在人体中一致显示出降低血压的作用。最近的研究表明，抑制交感神经过度活跃可能是这些物质发挥心脏保护作用的机制之一。事实上，血管中儿茶酚胺流量增加是多种心血管和心脏外疾病（包括高血压、肥胖、代谢综合征和心力衰竭）的主要发病机制。大量证据，主要来自实验研究，支持这样一种假设，即活性氧可能在中枢和外周水平产生交感兴奋作用。因此，抗氧化剂的补充可能会减少血管中的肾上腺素过载，并减轻对压力的心血管反应。
虽然补充“经典”抗氧化剂如 ROS 清除剂有许多限制，但增加富含多酚的食物的摄入量似乎是一种很有前途的新的治疗策略，可以减少增加的肾上腺素能张力的有害影响，特别是在原发性高血压中。
