The Sympathetic Nervous System and New Nonpharmacologic Approaches to Treating Hypertension: A Focus on Renal Denervation

Guido Grassi, Gino Seravalle, Gianmaria Brambilla, Giuseppe Mancia

Research output: Contribution to journalArticle

Abstract

The sympathetic nervous system is activated in a variety of cardiovascular and metabolic diseases. This is particularly the case for essential hypertension, in which various indices of adrenergic activity, such as plasma norepinephrine, norepinephrine spillover, and sympathetic nerve firing rate, are all well above the reference range of values, thereby documenting sympathetic overdrive. Evidence is available that sympathetic neural factors participate in disease progression, as well as in the development of cardiac and renal organ damage. These findings represent the rationale for therapeutic interventions that counteract the adrenergic overdrive in the hypertensive state. This paper, after reviewing the key findings of the neuroadrenergic abnormalities occurring in hypertension, examines the rationale and the technical details, as well as the results achieved so far, with the use of a new technique that allows the elimination of afferent and efferent innervation of the kidney in resistant hypertension, ie, the ablation of renal nerves. Strengths and potential limitations of the renal denervation approach are briefly addressed.

Original languageEnglish
Pages (from-to)311-317
Number of pages7
JournalCanadian Journal of Cardiology
Volume28
Issue number3
DOIs
Publication statusPublished - May 2012

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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