SYMPATHETIC ACTIVITY, BLOOD-PRESSURE VARIABILITY AND END-ORGAN DAMAGEIN HYPERTENSION

Animal studies have provided clearcut evidence that sympathetic factor s are involved in the development and maintenance of high blood pressu re (BP), This also appears to be the case in humans, in which sympathe tic activation, detected through plasma noradrenaline measurement, nor adrenaline spillover technique and direct recording of muscle sympathe tic nerve activity, has been shown to characterize the early phases of the hypertensive state and parallel its severity, Sympathetic factors also play in a variety of pathophysiological states frequently associ ated with hypertension, such as obesity, insulin resistance and athero sclerosis, In addition evidence has been collected that adrenergic fac tors represent one of the mechanisms involved in determining BP variab ility, which is strictly associated with end organ damage, Taken toget her these findings underline the importance that the therapeutical app roach to hypertension is aimed not only at lowering BP but also at red ucing sympathetic activity.