scholarly journals PATHOGENETIC TREATMENT OF PATIENTS WITH HYPERTENSION, DEPENDING ON THE LEVEL OF SYMPATHОADRENAL SYSTEM ACTIVITY

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
O. E. Alypova ◽  
V. O. Mochonyi ◽  
L. P. Kuznetsova ◽  
N. M. Protsenko ◽  
O. Y. Vasylchenko
Keyword(s):  
Nervous System ◽  
Sympathetic Nervous System ◽  
Arterial Hypertension ◽  
Healthy Subjects ◽  
Antihypertensive Treatment ◽  
Β Blocker ◽  
Sympathetic Nervous ◽  
The Individual ◽  
The Impact

Abstract Purpose of the study. Recently, new opportunities to optimize clinical efficacy and tolerability of treatment of patients with essential hypertension appeared. Determination of the indicators of increased activity of the sympathetic nervous system (SNS) in practice could contribute to differentiated treatment of patients with hypertension. Comparative estimation of influence of complex treatment with bisoprolol or amlodipine on the SNS activity parameters in patients with arterial hypertension (AH) of II stage. Materials and methods. 121 patients (men and women) with documented II stage AH were examined clinically. Concentrations of adrenaline, noradrenaline, dopamine and DOPA in urine were evaluated by spectrochromatography, endotheliumdependent vasodilation was studied using complex rheographic ReoCom Professional (HAI-Medicom, Ukraine). Patients were divided into 2 groups: if concentration of noradrenalin in urine exceeds healthy subjects levels more than on 20% – patients were added to basic treatment (enalapril, atorvastatin, aspirin) bisoprolol, if concentration of noradrenalin in urine exceeds healthy subjects levels less than on 20% – we added amlodipine. Statistic analysis was done on Apache OpenOffice (version 4.1) and PSPP (version 0.7.9). Results. The study showed that after treatment there was significant decrease of adrenalin, noradrenalin in 1st group . Increase of DOPA levels was higher in 1st group (Δ% = +46,5 [30,0; 55,4]% vs Δ% = +8,8 [–2,1 ; 16,0]%, (p < 0,05).). Trends in daily urinary excretion of adrenaline (–44,8%) and norepinephrine (–33,7%) showed the impact of effective Δ-blocker on the activity of pressor systems. DOPA excretion was increased significantly in both groups which can indirectly indicate hemodynamic load reduction in hypertensive patients. When choosing the individual antihypertensive treatment in patients with arterial hypertension, if excretion of noradrenalin is increased it is rationally to add adjuvant therapy with β-blockers. Conclusion. The results of our research can be applied into the practice of general practitioner as recommendations for individual selection of antihypertensive treatment depending on the activity of sympathetic nervous system. Keywords: arterial hypertension, treatment, sympathetic nervous system, β-blocker, calcium antagonists.

scholarly journals The role of the vegetative part of sympathetic nervous system in development of cardiovascular complications in patients with arterial hypertension: pharmacological aspects

2014 ◽  
Vol 11 (3) ◽  
pp. 88-94
Author(s):  
S R Gilyarevsky
Keyword(s):  
Nervous System ◽  
Sympathetic Nervous System ◽  
Arterial Hypertension ◽  
Cardiovascular System ◽  
Antihypertensive Agents ◽  
Cardiovascular Complications ◽  
Autonomic Regulation ◽  
Sympathetic Nervous ◽  
The Impact

Recently, we have determined new interest in studying the role of sympathetic part of autonomic division of nervous system (SANS) in the pathogenesis of arterial hypertension (AH), as well as in studying the role of agents, suppressing the activity of SANS, using for AH treatment, including the usage of antihypertensive agents and non-pharmacological methods. This article discusses the changes of autonomic regulation of the cardiovascular system in patients with AH. The role of these changes in the development of the functional and structured changes of the heart and systemic vessels can be observing during long-standing AH and will lead to the development of adverse clinical outcomes. We have been showing received data, associated with the impact of non-medicated and pharmacological approaches to the autonomic regulation of the cardiovascular system.

scholarly journals Pathophysiology of Resistant Hypertension: The Role of Sympathetic Nervous System

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Costas Tsioufis ◽  
Athanasios Kordalis ◽  
Dimitris Flessas ◽  
Ioannis Anastasopoulos ◽  
Dimitris Tsiachris ◽  
...  
Keyword(s):  
Nervous System ◽  
Sympathetic Nervous System ◽  
Resistant Hypertension ◽  
Antihypertensive Treatment ◽  
Treatment Options ◽  
Treatment Resistance ◽  
Obstructive Sleep ◽  
Cardiovascular Morbidity And Mortality ◽  
Sympathetic Nervous

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.

Ethnic differences in sympathetic nervous system-mediated energy expenditure

1991 ◽  
Vol 261 (6) ◽  
pp. E789-E794 ◽  
Author(s):  
M. F. Saad ◽  
S. A. Alger ◽  
F. Zurlo ◽  
J. B. Young ◽  
C. Bogardus ◽  
...  
Keyword(s):  
Nervous System ◽  
Energy Expenditure ◽  
Sympathetic Nervous System ◽  
Fat Mass ◽  
Weight Maintenance ◽  
Resting Metabolic Rate ◽  
Fat Free Mass ◽  
Beta Adrenoceptor ◽  
Sympathetic Nervous ◽  
The Impact

The impact of sympathetic nervous system (SNS) activity on energy expenditure (EE) was evaluated in nondiabetic Caucasian and Pima Indian men while on a weight-maintenance diet using two approaches as follows. 1) The relationship between 24-h EE, measured in a respiratory chamber, and 24-h urinary norepinephrine was studied in 36 Caucasians [32 +/- 8 (SD) yr, 95 +/- 41 kg, 22 +/- 13% fat] and 33 Pimas (29 +/- 6 yr, 103 +/- 28 kg, 30 +/- 9% fat). There was no difference between the two groups in 24-h EE (2,422 vs. 2,523 kcal/24 h) and in urinary norepinephrine (28 vs. 31 micrograms/24 h), even after adjusting for body size and composition. Twenty-four-hour EE correlated significantly with 24-h urinary norepinephrine in Caucasians (r = 0.78, P less than 0.001) but not in Pimas (r = 0.03), independent of fat-free mass (FFM), fat mass, and age. 2) The effect of beta-adrenoceptor blockade with propranolol (120 micrograms/kg FFM bolus and 1.2 micrograms.kg FFM-1.min-1 for 45 min) on the resting metabolic rate (RMR) was evaluated in 36 Caucasians (30 +/- 6 yr, 103 +/- 36 kg, 25 +/- 11% fat) and 32 Pimas (28 +/- 6 yr, 100 +/- 34 kg, 27 +/- 10% fat). The RMR was similar in the two groups (2,052 vs. 1,973 kcal/24 h) even after adjustment for FFM, fat mass, and age and dropped significantly after propranolol infusion in Caucasians (-3.9%, P less than 0.001) but not in Pimas (-0.8%, P = 0.07).(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals The role of beta-blockers in the treatment of hypertension in 2018 ESC/ESH guidelines

2018 ◽  
pp. 96-99
Author(s):  
A. O. Konradi ◽  
L. G. Ratova ◽  
I. V. Emelyanov ◽  
A. O. Nedoshivin
Keyword(s):  
Nervous System ◽  
Sympathetic Nervous System ◽  
Arterial Hypertension ◽  
Beta Blockers ◽  
Cardiovascular Morbidity And Mortality ◽  
The World ◽  
Treatment Of Hypertension ◽  
Sympathetic Nervous ◽  
New Guidelines

Arterial hypertension (AH) is the most common non­infectious disease in the world and in Russia, associated with high cardiovascular morbidity and mortality. In August 2018, new guidelines for the diagnosis and treatment of patients with arterial hypertension were presented at the European Congress of Cardiology. The article discusses the role of the sympathetic nervous system in the pathogenesis of hypertension and the current importance of beta­blockers in the treatment of hypertension.

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