Differences in muscle sympathetic nerve activity between patients with orthostatic hypertension and those with orthostatic normotensive hypertension

Q: What are the key findings of this study?

Orthostatic hypertension was associated with elevated resting MSNA burst frequency compared to normotensive controls.

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Orthostatic hypertension (n=18). Intervention: Orthostatic hypertension vs. Orthostatic normotensive hypertension. Primary outcome: Resting MSNA burst frequency (bursts/min) (p=<0.05).

Q: What question did this study set out to answer?

To determine whether resting muscle sympathetic nerve activity differs between patients with orthostatic hypertension and matched individuals with orthostatic normotensive hypertension.

Tadayuki Hirai; Hisayoshi Murai; Hiroyuki SUGIMOTO; Yusuke Mukai; Hideki Tokuhisa; Tatsunori Ikeda; Daisuke Kobayashi; Shigeo Takata; Kenji SAKATA; Soichiro Usui; Masayuki Takamura; Tadayuki Hirai; Hisayoshi Murai; Hiroyuki SUGIMOTO; Yusuke Mukai; Hideki Tokuhisa; Tatsunori Ikeda; Daisuke Kobayashi; Shigeo Takata; Kenji SAKATA; Soichiro Usui; Masayuki Takamura

doi:10.1016/j.autneu.2025.103366

Key result

Orthostatic hypertension is linked to ~36% higher resting MSNA burst frequency versus normotensive controls.

P<0.05
n=18

Why the study?

The relationship between orthostatic hypertension and sympathetic nerve activity is poorly understood.

Does resting muscle sympathetic nerve activity differ between patients with orthostatic hypertension and those with orthostatic normotensive hypertension?

Key Points

To determine whether resting muscle sympathetic nerve activity differs between patients with orthostatic hypertension and matched individuals with orthostatic normotensive hypertension.
Measured resting muscle sympathetic nerve activity (MSNA) in seven patients with orthostatic hypertension and 11 matched controls.
Resting MSNA burst frequency was significantly elevated in the orthostatic hypertension group compared to controls (38.4 ± 12.2 vs. 28.3 ± 5.7 bursts/min, P < 0.05).
Resting MSNA burst incidence was significantly higher in patients with orthostatic hypertension than in controls (61.1 ± 21.3 vs. 44.6 ± 11.1 bursts/100 heartbeats, P < 0.05).

Study Design

Type

Case-Control (n=18)

Structured PICO

Does resting muscle sympathetic nerve activity differ between patients with orthostatic hypertension and those with orthostatic normotensive hypertension?

P

Population

18 participants comprising 7 patients with orthostatic hypertension and 11 matched controls.

C

Comparator

11 matched controls with orthostatic normotensive hypertension

O

Outcome

Resting muscle sympathetic nerve activity (MSNA) burst frequency and burst incidencesurrogate

Main Result

Absolute Event Rate: 38.4% vs 28.3%

p-value: p=<0.05

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Implication

Orthostatic hypertension is strongly associated with sympathetic hyperactivity at rest, suggesting a physiological mechanism for increased cardiovascular risk in these patients.

Abstract

Orthostatic hypertension (OrthoHT), an excessive pressor response to standing, increases cardiovascular risk; however, its relationship with sympathetic nerve activity is poorly understood. This study aimed to assess differences in muscle sympathetic nerve activity (MSNA) between patients with OrthoHT and those with orthostatic normotensive hypertension. We measured resting MSNA in seven patients with OrthoHT and 11 matched controls. The OrthoHT group exhibited significantly elevated MSNA burst frequency (38.4 ± 12.2 vs. 28.3 ± 5.7 bursts/min, P < 0.05) and burst incidence (61.1 ± 21.3 vs. 44.6 ± 11.1 bursts/100 heartbeats, P < 0.05). In conclusion, OrthoHT is strongly associated with sympathetic hyperactivity at rest, suggesting that this may be a key physiological mechanism contributing to the increased cardiovascular risk observed in these patients.

Discussion

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Cite This Study

Hirai et al. (2025) conducted a case-control in Orthostatic hypertension (n=18). Orthostatic hypertension vs. Orthostatic normotensive hypertension was evaluated on Resting MSNA burst frequency (bursts/min) (p=<0.05). Orthostatic hypertension was associated with elevated resting MSNA burst frequency compared to normotensive controls.

synapsesocial.com/papers/6963224691e05aa366cb8df6 https://doi.org/10.1016/j.autneu.2025.103366

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Differences in muscle sympathetic nerve activity between patients with orthostatic hypertension and those with orthostatic normotensive hypertension

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Differences in muscle sympathetic nerve activity between patients with orthostatic hypertension and those with orthostatic normotensive hypertension

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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