Therapeutic strategies for targeting excessive central sympathetic activation in human hypertension.
Therapeutic strategies for targeting excessive central sympathetic activation in human hypertension.
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DOI：
10.1113/expphysiol.2009.047332
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发表时间：
2010-05
影响因子：
2.7
通讯作者：
Fadel PJ
中科院分区：
文献类型：
--
作者：
Fisher JP;Fadel PJ
高血压的发病机制及其进展方式是复杂的，多因素的，不完全理解。然而，从人类和高血压动物模型中积累的证据表明，过度的中枢交感神经活动（SNA）在触发和维持原发性高血压状态中起致病作用（所谓的“神经肾上腺素能假说”）。重要的是，增强的中枢交感神经流出也涉及与任何血压升高无关的过多病理生理过程的启动和进展，例如左心室肥大和心律失常。因此，交感神经系统构成了高血压中重要的假定药物靶点。然而，传统的药物治疗原发性高血压的方法在减少中枢交感神经流出方面似乎无效。近年来，针对神经源性高血压的治疗策略不断涌现。本报告将简要介绍这一主题的最新情况，特别侧重于人体研究，审查新的药理学方法（中枢交感神经阻滞剂、他汀类药物）、生活方式改变（有氧运动训练、减肥、减轻压力）和手术干预（肾去神经、慢性颈动脉压力反射刺激、脑深部刺激）在减少高血压中枢交感神经过度激活方面的疗效。
The pathogenesis of hypertension and its mode of progression are complex, multifactoral and incompletely understood. However, there is accumulating evidence from humans and animal models of hypertension indicating that excessive central sympathetic nerve activity (SNA) plays a pathogenic role in triggering and sustaining the essential hypertensive state (the so-called “neuroadrenergic hypothesis”). Importantly, augmented central sympathetic outflow has also been implicated in the initiation and progression of a plethora of pathophysiological processes independent of any increase in blood pressure, such as left ventricular hypertrophy and cardiac arrhythmias. Thus, the sympathetic nervous system constitutes an important putative drug target in hypertension. However, traditional pharmacological approaches for the management of essential hypertension appear ineffective in reducing central sympathetic outflow. Recently, several new and promising therapeutic strategies targeting neurogenic hypertension have been developed. The present report will provide a brief update of this topic with a particular emphasis on human studies examining the efficacy of novel pharmacological approaches (central sympatholytics, statins), lifestyle modification (aerobic exercise training, weight loss, stress reduction) and surgical intervention (renal denervation, chronic carotid baroreflex stimulation, deep brain stimulation) in reducing excessive central sympathetic activation in hypertension.
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影响因子：
2.7
作者：
Fisher, James P.;Young, Colin N.;Fadel, Paul J.
通讯作者：
Fadel, Paul J.
影响因子：
9
作者：
BRAUNWALD, NS;EPSTEIN, SE;BRAUNWALD, E
通讯作者：
BRAUNWALD, E
影响因子：
4.9
作者：
Esler, M;Lux, A;Lambert, G
通讯作者：
Lambert, G
DOI：
10.1536/jhj.44.693
发表时间：
2003-09-01
期刊：
JAPANESE HEART JOURNAL
影响因子：
--
作者：
Koldas, L;Ayan, F;Ikitimur, B
通讯作者：
Ikitimur, B
影响因子：
8.3
作者：
Flaa, Arnljot;Eide, Ivar K.;Rostrup, Morten
通讯作者：
Rostrup, Morten