title: Sympathetic activation in cardiovascular disease: evidence, clinical impact and therapeutic implications.
abstract: BACKGROUND
  The sympathetic nervous exerts a key role in cardiovascular homeostasis control by regulating cardiac output, systemic vascular resistance, heart rate and blood pressure.
  
  
  METHODS
  Data collected during the past 30 years have unequivocally shown that in a considerable number of cardiovascular as well as noncardiovascular disease there is a marked activation of the sympathetic nervous system which exerts in the long-term period unfavourable haemodynamic, metabolic, cardiovascular and renal effects.
  
  
  RESULTS
  This paper will review the current knowledge on the alterations in sympathetic function described in cardiovascular disease, with particular focus on hypertension, heart failure and myocardial infarction.
  
  
  CONCLUSIONS
  The consequences of the phoenomenon will be discussed together with its therapeutic implications. This will be done by examining the impact of nonpharmacological as well as pharmacological interventions on sympathetic cardiovascular drive. The effects of new invasive approaches, such as carotid baroreceptor stimulation as well as renal nerves ablation, will be also briefly discussed.
authors.affiliation: Clinica Medica, Dipartimento di Scienze della Salute, Universita' Milano-Bicocca, Milan, Italy.|IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.affiliation: Istituto Auxologico Italiano, Milan, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Seravalle
authors.affiliation: Clinica Medica, Dipartimento di Scienze della Salute, Universita' Milano-Bicocca, Milan, Italy.|Istituto Auxologico Italiano, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000628:therapy; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000379:methods; D006333:Heart Failure / Q000209:etiology / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000628:therapy; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy; D011311:Pressoreceptors; D013562:Sympathectomy / Q000379:methods
chemical_list: D002317:Cardiovascular Agents
keywords: Congestive heart failure; drug treatment; hypertension; myocardial infarction; prognosis; sympathetic nervous system