[The role of the sympathetic nervous system in essential arterial hypertension and organ damage].

Experimental evidence collected in animals and man supports the concept that adrenergic neural factors may be involved in the development of the hypertensive state and hypertension-related cardiovascular and metabolic complications. The various methodological approaches employed in evaluating sympathetic tone in man have shown that a hyperadrenergic state is evident in the early hypertensive phases. Sympathetic activation becomes more evident in stable hypertension and contributes to the maintenance of high blood pressure values. Adrenergic factors are also involved in the pathogenesis of cardiac and vascular hypertrophy, i.e. cardiovascular hypertensive complications that in the past have been regarded as mainly dependent on hemodynamic mechanisms. Sympathetic overactivity may also play an important role in the atherogenic process and may contribute to the insulin resistance state that often characterizes the hypertensive patient. The role of neural sympathetic factors in the pathophysiology of hypertension and its complications suggests that modulation of sympathetic activity should be an important target of modern antihypertensive treatment, aimed not only at lowering blood pressure, but also at reducing the patient's cardiovascular risk profile.