The sympathetic nervous system in hypertension and renal disease

The sympathetic nervous system plays a critical role in the initiation and development of some types of hypertension and renal diseases. In a subgroup of essential hypertension, sympathetic overactivity is implicated in linking insulin resistance, abnormal intracellular calcium handling and high blood pressure. Endothelium-derived autocrine-paracrine factors such as endothelin and nitric oxide, have been shown to influence the sympathetic nervous system, and thus to modify blood pressure and renal function. Although the action of each endothelial factor had been separately examined, the interaction between endothelin and nitric oxide has recently been found to modulate sympathetic nerve activity in an in-vivo hypertension model. Since elevated sympathetic activity is responsible for cardiovascular complications such as myocardial infarction, it is appropriate to choose antihypertensive drugs that reduce sympathetic nerve activity and attenuate reflex activation of the sympathetic nervous system.