title: Pathophysiology of resistant hypertension: the role of sympathetic nervous system.
abstract: Resistant hypertension (RH) is a powerful risk factor for cardiovascular morbidity and mortality. Among the characteristics of patients with RH, obesity, obstructive sleep apnea, and aldosterone excess are covering a great area of the mosaic of RH phenotype. Increased sympathetic nervous system (SNS) activity is present in all these underlying conditions, supporting its crucial role in the pathophysiology of antihypertensive treatment resistance. Current clinical and experimental knowledge points towards an impact of several factors on SNS activation, namely, insulin resistance, adipokines, endothelial dysfunction, cyclic intermittent hypoxaemia, aldosterone effects on central nervous system, chemoreceptors, and baroreceptors dysregulation. The further investigation and understanding of the mechanisms leading to SNS activation could reveal novel therapeutic targets and expand our treatment options in the challenging management of RH.
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, 3 Kolokotroni Street, P. Penteli, Athens 15236, Greece.
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Kordalis
authors.forename: Dimitris
authors.initials: D
authors.lastname: Flessas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Anastasopoulos
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tsiachris
authors.forename: Vasilios
authors.initials: V
authors.lastname: Papademetriou
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis