title: Gastrointestinal intervention ameliorates high blood pressure through antagonizing overdrive of the sympathetic nerve in hypertensive patients and rats.
abstract: BACKGROUND
  We investigated the hypothesis that the favorable effects of gastrointestinal (GI) intervention on hypertension (HTN) and cardiovascular (CV) disturbances are mediated by antagonizing overdrive of the sympathetic nervous system (SNS).
  
  
  RESULTS
  Hypertensive patients with metabolic disturbances underwent laparoscopic Roux-en-Y gastric bypass surgery, and spontaneously hypertensive rats (SHRs) underwent RYGB or sham surgery. Blood pressure (BP), heart rate (HR), endothelium-dependent flow-mediated dilation, and anthropometric as well as laboratory parameters were measured at baseline and during follow-up. Changes of BP and HR in response to cold stress, renal sympathetic nervous activity (RSNA), vasoconstriction induced by electrical field stimulation, microinjection of nucleus of the solitary tract (NTS), and CV function and structure were examined in SHRs with or without surgery. Compared with baseline, BP and HR were significantly reduced in both hypertensive patients with type 2 diabetes and rats. Impaired endothelial-dependent vasodilatation and metabolic disturbances in hypertensive patients were also ameliorated after surgery. CV disturbances were reversed by surgery in SHRs. Under acute cold exposure, the variations in BP and HR were smaller in surgically treated SHRs, compared to sham SHRs. RSNA and vasoconstriction induced by perivascular nerve stimulation as well as NTS-mediated changes of BP were decreased in surgically treated SHRs, compared to sham SHR. Weight loss did not affect BP and RSNA in sham SHRs.
  
  
  CONCLUSIONS
  GI intervention ameliorates HTN in both hypertensive patients and rats by inhibiting overdrive of the SNS. Therefore, targeting gastrointestine could be a novel strategy to treat HTN with metabolic disturbances.
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Hexuan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Pu
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China (W.T.).
authors.forename: Weidong
authors.initials: W
authors.lastname: Tong
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Yuanting
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Fang
authors.initials: F
authors.lastname: Sun
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Zhou
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Tao
authors.initials: T
authors.lastname: Yang
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Changyuan
authors.initials: C
authors.lastname: Meng
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Zongshi
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Zhencheng
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Daoyan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension, Chongqing, China (H.Z., Y.P., J.C., Y.C., F.S., Z.Z., Q.L., T.Y., C.M., Z.L., L.L., Z.Y., D.L., Z.Z.).
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000818:Animals; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002319:Cardiovascular System / Q000294:innervation*; D058639:Cold-Shock Response; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000175:diagnosis; D004195:Disease Models, Animal; D004558:Electric Stimulation; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D010535:Laparoscopy; D008297:Male; D008845:Microinjections; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011918:Rats, Inbred SHR; D017552:Solitary Nucleus / Q000187:drug effects / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage
chemical_list: D015415:Biomarkers; D005680:gamma-Aminobutyric Acid
keywords: gastric bypass surgery; gastrointestinal intervention; hypertension; sympathetic nervous system