| Clinical consequences of the autonomic imbalance in hypertension and congestive heart failure. | |
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MedLine Citation:
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PMID: 9540130 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The reduction of coronary mortality is not as large as one would expect from the observed blood pressure lowering in trials of antihypertensive medications. This is not surprising; hypertension is a complex disease where the high blood pressure is only one of numerous coronary risk factors. Sympathetic overactivity in hypertension, independent of the blood pressure, may be conducive to premature atherosclerosis by inducing insulin resistance and dyslipidemia. Through its trophic effect on blood vessels, sympathetic overactivity potentiates vasoconstriction. This, in turn, accelerates hypertension and the metabolic syndrome. The hypertrophy of small coronary arterioles decreases the coronary reserve and enhances coronary spasms. Tachycardia, which is due to increased sympathetic tone and a decreased parasympathetic tone, favors arrhythmias and sudden death in congestive heart failure and hypertension. Increased hematocrit is frequently found in male patients with hypertension, and high hematocrit is a predictor of coronary heart disease/thrombosis. The increase of hematocrit is in part due to an alpha adrenergic postcapillary venoconstriction. Enhanced sympathetic drive, insulin resistance and dyslipidemia have been demonstrated also in congestive heart failure, but the clinical importance of these findings is not fully understood. |
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Authors:
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S Julius; S Nesbitt |
Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: Scandinavian cardiovascular journal. Supplement Volume: 47 ISSN: 1401-7458 ISO Abbreviation: Scand Cardiovasc J Suppl Publication Date: 1998 |
Date Detail:
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Created Date: 1998-05-21 Completed Date: 1998-05-21 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9711058 Medline TA: Scand Cardiovasc J Suppl Country: NORWAY |
Other Details:
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Languages: eng Pagination: 23-30 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Antihypertensive Agents / therapeutic use Autonomic Nervous System / physiopathology* Blood Pressure / drug effects Heart Failure / physiopathology* Humans Hypertension / drug therapy, physiopathology* Muscle, Smooth, Vascular / innervation, physiopathology Vasoconstriction / physiology |
| Grant Support | |
ID/Acronym/Agency:
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DK 20572/DK/NIDDK NIH HHS; HL 37464/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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