Antihypertensive drugs and sympathetic nervous system

Several studies have demonstrated that essential hypertension is accompanie d by sympathetic activation, which contributes to blood pressure elevation. Sympathetic activation also has adverse consequences in hypertensive patie nts beyond initiating blood pressure elevation. There is evidence that neur al vasoconstriction has metabolic effects in skeletal muscle, impairing glu cose delivery to muscles. In the liver, retarding of post prandial clearanc e of lipids contributes to hyperlipidemia. Cardiac sympathetic activation i s a probable cause of sudden death in hearth failure. A trophic effect of s ympathetic activation on cardiovascular growth is also likely, contributing to the development of left ventricular hypertrophy. Consequently, one of t he major aims of antihypertensive therapy should be to attenuate sympatheti c tone. It is possible that, among the antihypertensive drugs available, those inhi biting the sympathetic nervous system might best reduce cardiovascular risk .