TY - JOUR
T1 - The sympathetic nervous system and the metabolic syndrome
AU - Mancia, Giuseppe
AU - Bousquet, Pascal
AU - Elghozi, Jean Luc
AU - Esler, Murray
AU - Grassi, Guido
AU - Julius, Stevo
AU - Reid, John
AU - Van Zwieten, Peter A.
PY - 2007/5
Y1 - 2007/5
N2 - Studies performed in the past two decades have unequivocally shown that several of the components of the metabolic syndrome are associated with indirect and direct markers of adrenergic overdrive. This is the case for hypertension and obesity, in which resting tachycardia, elevated plasma norepinephrine values, increased sympathetic nerve traffic, as well as augmented levels of total and regional norepinephrine spillover have been reported. This is also the case for insulin resistance, i.e. a metabolic condition frequently complicating the various components of the pathological condition identified as the 'metabolic syndrome'. After briefly describing the epidemiological and the cardiovascular risk profile of the disease, this paper will examine the behaviour of the sympathetic nervous system in the metabolic syndrome as well as the mechanisms potentially responsible for this neurogenic abnormality. This will be followed by an analysis of the role played by neuroadrenergic factors in disease progression as well as in the pathogenesis of its complications. Finally, the therapeutic implications of these findings will be highlighted.
AB - Studies performed in the past two decades have unequivocally shown that several of the components of the metabolic syndrome are associated with indirect and direct markers of adrenergic overdrive. This is the case for hypertension and obesity, in which resting tachycardia, elevated plasma norepinephrine values, increased sympathetic nerve traffic, as well as augmented levels of total and regional norepinephrine spillover have been reported. This is also the case for insulin resistance, i.e. a metabolic condition frequently complicating the various components of the pathological condition identified as the 'metabolic syndrome'. After briefly describing the epidemiological and the cardiovascular risk profile of the disease, this paper will examine the behaviour of the sympathetic nervous system in the metabolic syndrome as well as the mechanisms potentially responsible for this neurogenic abnormality. This will be followed by an analysis of the role played by neuroadrenergic factors in disease progression as well as in the pathogenesis of its complications. Finally, the therapeutic implications of these findings will be highlighted.
KW - Central sympatholytic drugs
KW - Hypertension
KW - Insulin
KW - Metabolic syndrome
KW - Obesity
KW - Sleep apnoea
KW - Sympathetic nervous system
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U2 - 10.1097/HJH.0b013e328048d004
DO - 10.1097/HJH.0b013e328048d004
M3 - Article
C2 - 17414649
AN - SCOPUS:34147127615
VL - 25
SP - 909
EP - 920
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 5
ER -