title: The autonomic nervous system and hypertension.
abstract: Physiological studies have long documented the key role played by the autonomic nervous system in modulating cardiovascular functions and in controlling blood pressure values, both at rest and in response to environmental stimuli. Experimental and clinical investigations have tested the hypothesis that the origin, progression, and outcome of human hypertension are related to dysfunctional autonomic cardiovascular control and especially to abnormal activation of the sympathetic division. Here, we review the recent literature on the adrenergic and vagal abnormalities that have been reported in essential hypertension, with emphasis on their role as promoters and as amplifiers of the high blood pressure state. We also discuss the possible mechanisms underlying these abnormalities and their importance in the development and progression of the structural and functional cardiovascular damage that characterizes hypertension. Finally, we examine the modifications of sympathetic and vagal cardiovascular influences induced by current nonpharmacological and pharmacological interventions aimed at correcting elevations in blood pressure and restoring the normotensive state.
authors.affiliation: From the IRCCS Istituto Auxologico Italiano, Milano, Italy (G.M.); Clinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Monza (Monza e Brianza), Italy (G.M., G.G.); and IRCCS Multimedica, Sesto San Giovanni, Milano, Italy (G.G.). giuseppe.mancia@unimib.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
authors.affiliation: From the IRCCS Istituto Auxologico Italiano, Milano, Italy (G.M.); Clinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Monza (Monza e Brianza), Italy (G.M., G.G.); and IRCCS Multimedica, Sesto San Giovanni, Milano, Italy (G.G.).
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D018450:Disease Progression; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology
keywords: hypertension; parasympathetic nervous system; sympathetic nervous system