Comments on Point:Counterpoint: The dominant contributor to systemic hypertension: Chronic activation of the sympathetic nervous system vs. Activation of the intrarenal renin-angiotensin system. Sympathetic activation is the dominant contributor to systemic hypertension.

摘要

The role of the sympathetic nervous system in the development and maintenance of hypertension has been studied for over a century and there is increasing evidence showing that chronic sympathetic activation is a dominant contributor to most forms of hypertension in humans. We, therefore, support the concept of Esler et al (1). It is well known that hypertension is characterized by increased peripheral vascular resistance, which is attributable to increased vasoconstriction and endothelial dysfunction. Numerous studies have shown that activation of the sympathetic nervous system causes vasoconstriction through an alpha-adrenergic mechanism. Recent human research has found that sympathetic activation significantly decreases endothelial-dependent vaso-dilatation and impairs endothelial function (3, 5).