Sympathetic nerve biology in essential hypertension
Sympathetic nerve biology in essential hypertension
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DOI：
10.1046/j.1440-1681.2001.03566.x
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发表时间：
2001-12-01
影响因子：
2.9
通讯作者：
Lambert, G
中科院分区：
文献类型：
--
作者：
Esler, M;Rumantir, M;Lambert, G
1.虽然交感神经激活在原发性高血压发病机制中的重要性已被充分证实，但交感神经功能障碍的确切病理生理机制仍有待阐明。对于去甲肾上腺素从肾脏和心脏到血浆的溢出增加有几种可能的解释，这是支持原发性高血压神经源性基础的关键证据，除了交感神经放电率增加的明显原因之一。在自发性高血压大鼠中有很好的证据表明，人类高血压中交感神经支配密度可能增加，目前我们正在研究这种可能性。肾上腺素共传递存在于原发性高血压患者的心脏交感神经中，这是他们暴露于高水平压力的推定证据，也是通过突触前增加去甲肾上腺素释放而观察到的心脏去甲肾上腺素溢出增加的可能基础。4.表型证据也存在错误的去甲肾上腺素再摄取到心脏的交感神经在原发性高血压，一种异常，将放大交感神经信号，损害从突触间隙去除去甲肾上腺素。
1. Although the importance of sympathetic nervous activation in the pathogenesis of essential hypertension is well documented, the exact pathophysiology of the sympathetic nervous dysfunction present remains to be delineated. There are several possible explanations for the increased spillover of noradrenaline from the kidneys and heart to plasma, a key piece of evidence supporting the neurogenic basis of essential hypertension, in addition to the obvious one of an increased rate of sympathetic nerve firing.2. The possibility that there may be an increase in the density of sympathetic innervation in human hypertension, well documented in the spontaneously hypertensive rat, is currently under investigation by us.3. Adrenaline cotransmission is present in the cardiac sympathetic nerves of patients with essential hypertension, presumptive evidence of their exposure to high levels of stress and a possible basis for the observed increase in cardiac noradrenaline spillover, through presynaptic augmentation of noradrenaline release.4. Phenotypic evidence exists also of faulty noradrenaline reuptake into the sympathetic nerves of the heart in essential hypertension, an abnormality that would amplify the sympathetic neural signal by impairing removal of noradrenaline from the synaptic cleft.