Grassi G, Mancia G
Cattedra di Medicina Interna, Università degli Studi di Milano.
Ann Ital Med Int. 1995 Oct;10 Suppl:115S-120S.
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.
在动物和人体中收集的实验证据支持这样一种概念，即肾上腺素能神经因素可能参与高血压状态以及与高血压相关的心血管和代谢并发症的发生发展。在评估人体交感神经张力时采用的各种方法表明，在高血压早期阶段，高肾上腺素能状态很明显。在稳定型高血压中，交感神经激活变得更加明显，并有助于维持高血压值。肾上腺素能因素也参与心脏和血管肥大的发病机制，即过去被认为主要依赖血流动力学机制的心血管高血压并发症。交感神经过度活跃在动脉粥样硬化过程中也可能起重要作用，并且可能导致高血压患者常有的胰岛素抵抗状态。神经交感因素在高血压及其并发症的病理生理学中的作用表明，调节交感神经活动应该是现代抗高血压治疗的一个重要目标，其目的不仅是降低血压，还在于降低患者的心血管风险状况。
