{"title":"交感神经系统在顽固性高血压中的作用:病理生理和临床方面","authors":"A. Orekhov, L. Karazhanova","doi":"10.18705/1607-419x-2022-28-4-348-356","DOIUrl":null,"url":null,"abstract":"Resistant arterial hypertension (HTN) is a significant risk factor for cardiovascular disease and mortality. Such clinical conditions as obesity, obstructive sleep apnea and hyperaldosteronism are interrelated links of the clinical phenotype of these patients. At the same time, these conditions are interrelated by the pathophysiological basis, i.e. activity of the sympathetic nervous system. Objective. To systematize data on the role of persistent sympathetic nervous system hyperactivation in the development and progression of resistant HTN. Design and methods. We searched for clinical studies and systematic reviews in databases (PubMed, Cochrane Library) examining the role of sympathetic overdrive, as well as treatment methods for resistant HTN aimed at blocking sympathetic activation. Results. Increased activity of the sympathetic nervous system is one of the most important links in the formation of resistance to antihypertensive therapy. Moreover, it is the chronic sympathetic overdrive that unites the most common risk factors of resistant HTN, namely obstructive sleep apnea, obesity and insulin resistance, renin-angiotensin system activation, and aldosterone hyperproduction. Conclusions. The increased interest in the study of the sympathetic nervous system in recent decades has contributed to the accumulation of new data on the pathophysiological and clinical aspects of resistant HTN, as well as expanded its treatment methods by introducing into clinical practice the technique of sympathetic denervation of the renal arteries. Further study of sympathetic activation contributes to the development of new therapeutic techniques and will change the management of patients with resistant HTN.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"53 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The role of the sympathetic nervous system in resistant hypertension: pathophysiological and clinical aspects\",\"authors\":\"A. Orekhov, L. Karazhanova\",\"doi\":\"10.18705/1607-419x-2022-28-4-348-356\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Resistant arterial hypertension (HTN) is a significant risk factor for cardiovascular disease and mortality. Such clinical conditions as obesity, obstructive sleep apnea and hyperaldosteronism are interrelated links of the clinical phenotype of these patients. At the same time, these conditions are interrelated by the pathophysiological basis, i.e. activity of the sympathetic nervous system. Objective. To systematize data on the role of persistent sympathetic nervous system hyperactivation in the development and progression of resistant HTN. Design and methods. We searched for clinical studies and systematic reviews in databases (PubMed, Cochrane Library) examining the role of sympathetic overdrive, as well as treatment methods for resistant HTN aimed at blocking sympathetic activation. Results. Increased activity of the sympathetic nervous system is one of the most important links in the formation of resistance to antihypertensive therapy. Moreover, it is the chronic sympathetic overdrive that unites the most common risk factors of resistant HTN, namely obstructive sleep apnea, obesity and insulin resistance, renin-angiotensin system activation, and aldosterone hyperproduction. Conclusions. The increased interest in the study of the sympathetic nervous system in recent decades has contributed to the accumulation of new data on the pathophysiological and clinical aspects of resistant HTN, as well as expanded its treatment methods by introducing into clinical practice the technique of sympathetic denervation of the renal arteries. Further study of sympathetic activation contributes to the development of new therapeutic techniques and will change the management of patients with resistant HTN.\",\"PeriodicalId\":37695,\"journal\":{\"name\":\"Arterial Hypertension (Russian Federation)\",\"volume\":\"53 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arterial Hypertension (Russian Federation)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18705/1607-419x-2022-28-4-348-356\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arterial Hypertension (Russian Federation)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18705/1607-419x-2022-28-4-348-356","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
The role of the sympathetic nervous system in resistant hypertension: pathophysiological and clinical aspects
Resistant arterial hypertension (HTN) is a significant risk factor for cardiovascular disease and mortality. Such clinical conditions as obesity, obstructive sleep apnea and hyperaldosteronism are interrelated links of the clinical phenotype of these patients. At the same time, these conditions are interrelated by the pathophysiological basis, i.e. activity of the sympathetic nervous system. Objective. To systematize data on the role of persistent sympathetic nervous system hyperactivation in the development and progression of resistant HTN. Design and methods. We searched for clinical studies and systematic reviews in databases (PubMed, Cochrane Library) examining the role of sympathetic overdrive, as well as treatment methods for resistant HTN aimed at blocking sympathetic activation. Results. Increased activity of the sympathetic nervous system is one of the most important links in the formation of resistance to antihypertensive therapy. Moreover, it is the chronic sympathetic overdrive that unites the most common risk factors of resistant HTN, namely obstructive sleep apnea, obesity and insulin resistance, renin-angiotensin system activation, and aldosterone hyperproduction. Conclusions. The increased interest in the study of the sympathetic nervous system in recent decades has contributed to the accumulation of new data on the pathophysiological and clinical aspects of resistant HTN, as well as expanded its treatment methods by introducing into clinical practice the technique of sympathetic denervation of the renal arteries. Further study of sympathetic activation contributes to the development of new therapeutic techniques and will change the management of patients with resistant HTN.
期刊介绍:
The main aims of the Journal include collecting and generalizing the knowledge in hypertensiology; education and professional development of cardiologists and medical doctors of other specialties, who deal with different issues regarding diagnostics, management and prevention of hypertension in both clinical practice and research. The Journal also calls attention to the most urgent and up-to-date questions in hypertensiology, cardiology and related sciences. There are additional objectives, such as increasing the availability, accessibility and recognition of Russian medical scientific achievements at the international level by improving the quality of the publication and the way they are presented; enabling the exchange of opinions and information between scientists and their wider communication. The main criteria for publication selection fit with the mentioned objectives and include currency, singularity, scientific and practical novelty, applied relevance etc.