Mancia G, Seravalle G, Grassi G
Cattedra di Medicina Interna I, Università degli Studi di Milano, Ospedale S. Gerardo dei Tintori di Monza.
Ann Ital Med Int. 1997 Oct-Dec;12(4):217-22.
Animal models have shown that hypertension may be accompanied by an increase in sympathetic activity. The findings of increased plasma norepinephrine or increased muscle sympathetic nerve traffic have now provided clear evidence, however, that sympathetic activity is increased in essential hypertension and that adrenergic neural mechanisms are already involved in the early phase of this condition. Furthermore, in the early and late phases of hypertension, the presence of other cardiovascular risk factors frequently accompanying hypertension such as obesity, insulin-resistance, and smoking, concomitant with hypertension, brings about sympathetic activation which may be superimposed on the activation resulting from the hypertensive state itself. Finally, sympathetic activation is directly involved in the progression of end-organ damage and plays a paramount role in the cardiovascular structural changes typical of the blood pressure elevation occurring in left ventricular hypertrophy, arteriolar remodeling, and atherosclerosis. These findings underscore the importance of aiming anti-hypertensive treatment at the reduction not only of blood pressure levels, but also of enhanced sympathetic cardiovascular drive.
动物模型表明，高血压可能伴有交感神经活动增加。然而，血浆去甲肾上腺素增加或肌肉交感神经活动增强的研究结果现已提供了明确的证据，即原发性高血压患者的交感神经活动增加，且肾上腺素能神经机制已参与到该疾病的早期阶段。此外，在高血压的早期和晚期，经常伴随高血压出现的其他心血管危险因素，如肥胖、胰岛素抵抗和吸烟，与高血压同时存在，会导致交感神经激活，这可能叠加在高血压状态本身所引起的激活之上。最后，交感神经激活直接参与终末器官损害的进展，并在左心室肥厚、小动脉重塑和动脉粥样硬化等典型血压升高所导致的心血管结构变化中起至关重要的作用。这些发现强调了抗高血压治疗不仅要降低血压水平，还要降低增强的交感神经心血管驱动的重要性。
