Overweight and sympathetic overactivity in black Americans

A large body of clinical investigation implicates an important role for the sympathetic nervous system in linking obesity with hypertension. However, the experimental support for this hypothesis is derived from strictly white cohorts. The goal of this study was to determine whether being overweight begets sympathetic overactivity in black Americans, the ethnic minority at highest risk for hypertension. We recorded postganglionic sympathetic nerve discharge with microelectrodes in muscle nerve fascicles of the peroneal n erve in 92 normotensive young adult black men and women within a wide range of body mass index. The same experiments were performed in a control group of 45 normotensive white men and women of similar ages and body mass indic es. The major new findings are 2-fold. First, in young, normotensive, overt ly healthy black women, being overweight begets sympathetic overactivity (r =0.45, P=0.0009), a putative intermediate phenotype for incident hypertensi on. Second, in black men, sympathetic nerve discharge is dissociated from b ody mass index (r=0.03, P=NS). This dissociation is explained in part by a 20% to 40% higher rate of sympathetic nerve discharge in lean black men com pared with lean white men and lean black and white women (28+/-3 versus 18/-2, 21+/-2, and 17+/-2 bursts/min, respectively; P<0.05). Sympathetic nerv e discharge in lean black men is comparable to that of overweight black men and women as well as white men and women. These data provide the first mic roneurographic evidence for tonic central sympathetic overactivity in black s, both adiposity-related sympathetic overactivity in black women and adipo sity-independent sympathetic overactivity in black men.