systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»systhiper-374Research ArticleОБЗОРЫРоль повышенной активности симпатического отдела вегетативной нервной системы в развитии осложнений сердечно-сосудистых заболеваний у больных артериальной гипертонией: фармакологические аспекты‌‌The role of the vegetative part of sympathetic nervous system in development of cardiovascular complications in patients with arterial hypertension: pharmacological aspectsГиляревскийС. Р.GilyarevskyS. R.noemail@neicon.ruГБОУ ДПО Российская медицинская академия последипломного образования Минздрава РоссииРоссия2014231220221138894Copyright © Гиляревский С.Р., 20222022Гиляревский С.Р.Gilyarevsky S.R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/374

В последние годы возобновился интерес к изучению роли симпатического отдела вегетативной нервной системы (СОВНС) в патогенезе артериальной гипертонии (АГ), а также к оценке роли вмешательств, подавляющих активность СОВНС, для лечения АГ, включая как применение антигипертензивных средств, так и нефармакологических методов. В данной статье обсуждаются данные об изменении автономной регуляции сердечно-сосудистой системы у больных с АГ, возможная роль таких изменений в развитии функциональных и структурных изменений сердца, а также сосудов большого круга кровообращения, которые отмечаются при длительном течение АГ и приводят к развитию неблагоприятных клинических исходов. Приведены имеющиеся данные о влиянии нелекарственных и фармакологических подходов к автономной регуляции сердечно-сосудистой системы.

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.

симпатическая нервная системаартериальная гипертонияпрепараты центрального действиямоксонидинsympathetic nervous systemarterial hypertensioncentrally-acting drugsmoxonidineReferencesDi Bona G.F. Sympathetic nervous system and hypertension. Hypertension 2013; 61: 556-60.Di Bona G.F. Sympathetic nervous system and hypertension. Hypertension 2013; 61: 556-60.Mancia G, Grassi G. The Autonomic Nervous System and Hypertension. Circ Res 2014; 114: 1804-14.Mancia G, Grassi G. The Autonomic Nervous System and Hypertension. Circ Res 2014; 114: 1804-14.Folkow B. Physiological aspects of primary hypertension. Physiol Rev 1982; 62: 347-504.Folkow B. Physiological aspects of primary hypertension. Physiol Rev 1982; 62: 347-504.Oparil S. The sympathetic nervous system in clinical and experimental hypertension. Kidney Int 1986; 30: 437-52.Oparil S. The sympathetic nervous system in clinical and experimental hypertension. Kidney Int 1986; 30: 437-52.Mark A.L. The sympathetic nervous system in hypertension: a potential long - term regulator of arterial pressure. J Hypertens (Suppl.) 1996; 14: S159-S165.Mark A.L. The sympathetic nervous system in hypertension: a potential long - term regulator of arterial pressure. J Hypertens (Suppl.) 1996; 14: S159-S165.Mancia G, Grassi G, Giannattasio C, Seravalle G. Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension 1999; 34: 724-8.Mancia G, Grassi G, Giannattasio C, Seravalle G. Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension 1999; 34: 724-8.Palatini P, Julius S. The role of cardiac autonomic function in hypertension and cardiovascular disease. Curr Hypertens Rep 2009; 11: 199-205.Palatini P, Julius S. The role of cardiac autonomic function in hypertension and cardiovascular disease. Curr Hypertens Rep 2009; 11: 199-205.Grassi G. Assessment of sympathetic cardiovascular drive in human hypertension: achievements and perspectives. Hypertension 2009; 54: 690-7.Grassi G. Assessment of sympathetic cardiovascular drive in human hypertension: achievements and perspectives. Hypertension 2009; 54: 690-7.Esler M. Sympathetic nervous system moves toward center stage in cardiovascular medicine: from Thomas Willis to resistant hypertension. Hypertension 2014; 63: e25-e32.Esler M. Sympathetic nervous system moves toward center stage in cardiovascular medicine: from Thomas Willis to resistant hypertension. Hypertension 2014; 63: e25-e32.Bakris G, Nathan S. Renal denervation and left ventricular mass regression: a benefit beyond blood pressure reduction? J Am Coll Cardiol 2014; 63: 1924-5.Bakris G, Nathan S. Renal denervation and left ventricular mass regression: a benefit beyond blood pressure reduction? J Am Coll Cardiol 2014; 63: 1924-5.Mc Crory W.W, Klein A.A, Rosenthal R.A. Blood pressure, heart rate, and plasma catecholamines in normal and hypertensive children and their siblings at rest and after standing. Hypertension 1982; 4: 507-13.Mc Crory W.W, Klein A.A, Rosenthal R.A. Blood pressure, heart rate, and plasma catecholamines in normal and hypertensive children and their siblings at rest and after standing. Hypertension 1982; 4: 507-13.Horikoshi Y, Tajima I, Igarashi H et al. The adreno - sympathetic system, the genetic predisposition to hypertension, and stress. Am J Med Sci 1985; 289: 186-91.Horikoshi Y, Tajima I, Igarashi H et al. The adreno - sympathetic system, the genetic predisposition to hypertension, and stress. Am J Med Sci 1985; 289: 186-91.Ferrara L.A, Moscato T.S, Pisanti N et al. Is the sympathetic nervous system altered in children with familial history of arterial hypertension? Cardiology 1988; 75: 200-5.Ferrara L.A, Moscato T.S, Pisanti N et al. Is the sympathetic nervous system altered in children with familial history of arterial hypertension? Cardiology 1988; 75: 200-5.Perini C, Muller F.B, Rauchfleisch U et al. Psychosomatic factors in borderline hypertensive subjects and offspring of hypertensive parents. Hypertension 1990; 16: 627-34.Perini C, Muller F.B, Rauchfleisch U et al. Psychosomatic factors in borderline hypertensive subjects and offspring of hypertensive parents. Hypertension 1990; 16: 627-34.Bianchetti M.G, Weidmann P, Beretta-Piccoli C. Disturbed noradrenergic blood pressure control in normotensive members of hypertensive families. Br Heart J 1984; 51: 306-11.Bianchetti M.G, Weidmann P, Beretta-Piccoli C. Disturbed noradrenergic blood pressure control in normotensive members of hypertensive families. Br Heart J 1984; 51: 306-11.Singh J.P, Larson M.G, Manolio T.A et al. Blood pressure response during treadmill testing as a risk factor for new - onset hypertension. The Framingham heart study. Circulation 1999; 99: 1831-6.Singh J.P, Larson M.G, Manolio T.A et al. Blood pressure response during treadmill testing as a risk factor for new - onset hypertension. The Framingham heart study. Circulation 1999; 99: 1831-6.Matthews C.E, Pate R.R, Jackson K.L, et al. Exaggerated blood pressure response to dynamic exercise and risk of future hypertension. J Clin Epidemiol 1998; 51: 29-35.Matthews C.E, Pate R.R, Jackson K.L, et al. Exaggerated blood pressure response to dynamic exercise and risk of future hypertension. J Clin Epidemiol 1998; 51: 29-35.Ferrier C, Cox H, Esler M. Elevated total body noradrenaline spillover in normotensive members of hypertensive families. Clin Sci (Lond) 1993; 84: 225-30.Ferrier C, Cox H, Esler M. Elevated total body noradrenaline spillover in normotensive members of hypertensive families. Clin Sci (Lond) 1993; 84: 225-30.Yamada Y, Miyajima E, Tochikubo O et al. Impaired baroreflex changes in muscle sympathetic nerve activity in adolescents who have a family history of essential hypertension. J Hypertens (Suppl.) 1988; 6: S525-S528.Yamada Y, Miyajima E, Tochikubo O et al. Impaired baroreflex changes in muscle sympathetic nerve activity in adolescents who have a family history of essential hypertension. J Hypertens (Suppl.) 1988; 6: S525-S528.Smith P.A, Graham L.N, Mackintosh A.F et al. Sympathetic neural mechanisms in white - coat hypertension. J Am Coll Cardiol 2002; 40: 126-32.Smith P.A, Graham L.N, Mackintosh A.F et al. Sympathetic neural mechanisms in white - coat hypertension. J Am Coll Cardiol 2002; 40: 126-32.Smith P.A, Graham L.N, Mackintosh A.F et al. Relationship between central sympathetic activity and stages of human hypertension. Am J Hypertens 2004; 17: 217-22.Smith P.A, Graham L.N, Mackintosh A.F et al. Relationship between central sympathetic activity and stages of human hypertension. Am J Hypertens 2004; 17: 217-22.Grassi G, Seravalle G, Trevano F.Q et al. Neurogenic abnormalities in masked hypertension. Hypertension 2007; 50: 537-42.Grassi G, Seravalle G, Trevano F.Q et al. Neurogenic abnormalities in masked hypertension. Hypertension 2007; 50: 537-42.Mancia G, Bombelli M, Sega R, Grassi G. White coat and masked hypertension. In: Black H.R, Elliott W.J, eds. Hypertension. A Companion to Braunwald’s Heart Disease. Saunders Elsevier: Philadelphia, PA, 2012; p. 64-8.Mancia G, Bombelli M, Sega R, Grassi G. White coat and masked hypertension. In: Black H.R, Elliott W.J, eds. Hypertension. A Companion to Braunwald’s Heart Disease. Saunders Elsevier: Philadelphia, PA, 2012; p. 64-8.Maver J, Struci M, Accetto R. Autonomic nervous system in normotensive subjects with a family history of hypertension. Clin Auton Res 2004; 14: 369-75.Maver J, Struci M, Accetto R. Autonomic nervous system in normotensive subjects with a family history of hypertension. Clin Auton Res 2004; 14: 369-75.Julius S, Krause L, Schork N.J et al. Hyperkinetic borderline hypertension in Tecumseh, Michigan. J Hypertens 1991; 9: 77-84.Julius S, Krause L, Schork N.J et al. Hyperkinetic borderline hypertension in Tecumseh, Michigan. J Hypertens 1991; 9: 77-84.Bohm R, van Baak M, van Hooff M et al. Salivary flow in borderline hypertension. Klin Wochenschr 1985; 63 (Suppl. 3): 154-6.Bohm R, van Baak M, van Hooff M et al. Salivary flow in borderline hypertension. Klin Wochenschr 1985; 63 (Suppl. 3): 154-6.Julius S, Pascual A.V, London R. Role of parasympathetic inhibition in the hyperkinetic type of borderline hypertension. Circulation 1971; 44: 413-8.Julius S, Pascual A.V, London R. Role of parasympathetic inhibition in the hyperkinetic type of borderline hypertension. Circulation 1971; 44: 413-8.Esler M, Lambert G, Jennings G. Regional norepinephrine turnover in human hypertension. Clin Exp Hypertens A 1989; 11 (Suppl. 1): 75-89.Esler M, Lambert G, Jennings G. Regional norepinephrine turnover in human hypertension. Clin Exp Hypertens A 1989; 11 (Suppl. 1): 75-89.Anderson E.A, Sinkey C.A, Lawton W.J, Mark A.L. Elevated sympathetic nerve activity in borderline hypertensive humans: evidence from directintraneural recordings. Hypertension 1988; 14: 1277-83.Anderson E.A, Sinkey C.A, Lawton W.J, Mark A.L. Elevated sympathetic nerve activity in borderline hypertensive humans: evidence from directintraneural recordings. Hypertension 1988; 14: 1277-83.Hering D, Kara T, Kucharska W et al. High - normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests. Blood Press 2013; 22: 183-7.Hering D, Kara T, Kucharska W et al. High - normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests. Blood Press 2013; 22: 183-7.Blankestijn P.J, Man in’t Veld A.J, Tulen J et al. Support for adrenaline - hypertension hypothesis: 18 hour pressor effect after 6 hours adrenaline infusion. Lancet 1988; 2: 1386-9.Blankestijn P.J, Man in’t Veld A.J, Tulen J et al. Support for adrenaline - hypertension hypothesis: 18 hour pressor effect after 6 hours adrenaline infusion. Lancet 1988; 2: 1386-9.Brodde O.E, Daul A, O’Hara N, Bock K.D. Increased density and responsiveness of alpha 2 and beta - adrenoceptors in circulating blood cells of essential hypertensive patients. J Hypertens Suppl 1984; 2: S111-S114.Brodde O.E, Daul A, O’Hara N, Bock K.D. Increased density and responsiveness of alpha 2 and beta - adrenoceptors in circulating blood cells of essential hypertensive patients. J Hypertens Suppl 1984; 2: S111-S114.Brodde O.E. Beta - adrenoreceptors in cardiac disease. Pharmacol Ther 1993; 60: 405-30.Brodde O.E. Beta - adrenoreceptors in cardiac disease. Pharmacol Ther 1993; 60: 405-30.Valentini M, Julius S, Palatini P et al. Attenuation of the haemodynamic, metabolic and energy responses to iosproterenol in patients with hypertension. J Hypertens 2004; 22: 1999-2006.Valentini M, Julius S, Palatini P et al. Attenuation of the haemodynamic, metabolic and energy responses to iosproterenol in patients with hypertension. J Hypertens 2004; 22: 1999-2006.Grassi G, Seravalle G, Stella M.L, Mancia G. Pathophysiological aspects of hypertensive heart disease in women. J Hypertens 2002; 20 (Suppl. 2): S6-S10.Grassi G, Seravalle G, Stella M.L, Mancia G. Pathophysiological aspects of hypertensive heart disease in women. J Hypertens 2002; 20 (Suppl. 2): S6-S10.Narkiewicz K, Phillips B.G, Kato M et al. Gender - selective interaction between aging, blood pressure, and sympathetic nerve activity. Hypertension 2005; 45: 522-25.Narkiewicz K, Phillips B.G, Kato M et al. Gender - selective interaction between aging, blood pressure, and sympathetic nerve activity. Hypertension 2005; 45: 522-25.Grassi G, Seravalle G, Bertinieri G et al. Sympathetic and reflex alterations in systo - diastolic and systolic hypertension of the elderly. J Hypertens 2000; 18: 587-93.Grassi G, Seravalle G, Bertinieri G et al. Sympathetic and reflex alterations in systo - diastolic and systolic hypertension of the elderly. J Hypertens 2000; 18: 587-93.Grassi G, Cattaneo B.M, Seravalle G et al. Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension 1998; 31: 68-72.Grassi G, Cattaneo B.M, Seravalle G et al. Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension 1998; 31: 68-72.Schobel H.P, Fischer T, Heuszer K et al. Preeclampsia - a state of sympathetic overactivity. N Engl J Med 1996; 335: 1480-5.Schobel H.P, Fischer T, Heuszer K et al. Preeclampsia - a state of sympathetic overactivity. N Engl J Med 1996; 335: 1480-5.Grassi G, Seravalle G, Dell’Oro R et al. Adrenergic and reflex abnormalities in obesity - related hypertension. Hypertension 2000; 36: 538-42.Grassi G, Seravalle G, Dell’Oro R et al. Adrenergic and reflex abnormalities in obesity - related hypertension. Hypertension 2000; 36: 538-42.Grassi G, Dell’Oro R, Quarti-Trevano F et al. Neuroadrenergic and reflex abnormalities in patients with metabolic syndrome. Diabetologia 2005; 48: 1359-65.Grassi G, Dell’Oro R, Quarti-Trevano F et al. Neuroadrenergic and reflex abnormalities in patients with metabolic syndrome. Diabetologia 2005; 48: 1359-65.Huggett R.J, Scott E.M, Gilbey S.G et al. Impact of type 2 diabetes mellitus on sympathetic neural mechanisms in hypertension. Circulation 2003; 108: 3097-3101.Huggett R.J, Scott E.M, Gilbey S.G et al. Impact of type 2 diabetes mellitus on sympathetic neural mechanisms in hypertension. Circulation 2003; 108: 3097-3101.Brands M.W, Hall J.E. Insulin resistance, hyperinsulinemia, and obesity - associated hypertension. J Am Soc Nephrol 1992; 3: 1064-77.Brands M.W, Hall J.E. Insulin resistance, hyperinsulinemia, and obesity - associated hypertension. J Am Soc Nephrol 1992; 3: 1064-77.Scherrer U, Sartori C. Insulin as a vascular and sympathoexcitatory hormone: implications for blood pressure regulation, insulin sensitivity, and cardiovascular morbidity. Circulation 1997; 96: 4104-13.Scherrer U, Sartori C. Insulin as a vascular and sympathoexcitatory hormone: implications for blood pressure regulation, insulin sensitivity, and cardiovascular morbidity. Circulation 1997; 96: 4104-13.Mancia G, Bombelli M, Corrao G et al. Metabolic syndrome in the PressioniArterioseMonitorate E LoroAssociazioni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis. Hypertension 2007; 49: 40-7.Mancia G, Bombelli M, Corrao G et al. Metabolic syndrome in the PressioniArterioseMonitorate E LoroAssociazioni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis. Hypertension 2007; 49: 40-7.Klein I.H, Ligtenberg G, Neumann J et al. Sympathetic nerve activity is inappropriately increased in chronic renal disease. J Am Soc Nephrol 2003; 14: 3239-44.Klein I.H, Ligtenberg G, Neumann J et al. Sympathetic nerve activity is inappropriately increased in chronic renal disease. J Am Soc Nephrol 2003; 14: 3239-44.Grassi G, Quarti-Trevano F, Seravalle G et al. Early sympathetic activation in the initial clinical stages of chronic renal failure. Hypertension 2011; 57: 846-51.Grassi G, Quarti-Trevano F, Seravalle G et al. Early sympathetic activation in the initial clinical stages of chronic renal failure. Hypertension 2011; 57: 846-51.Burns J, Sivananthan M.U, Ball S.G et al. Relationship between central sympathetic drive and magnetic resonance imaging - determined left ventricular mass in essential hypertension. Circulation 2007; 115: 1999-2005.Burns J, Sivananthan M.U, Ball S.G et al. Relationship between central sympathetic drive and magnetic resonance imaging - determined left ventricular mass in essential hypertension. Circulation 2007; 115: 1999-2005.Grassi G, Seravalle G, Quarti-Trevano F et al. Sympathetic and baroreflex cardiovascular control in hypertension - related left ventricular dysfunction. Hypertension 2009; 53: 205-9.Grassi G, Seravalle G, Quarti-Trevano F et al. Sympathetic and baroreflex cardiovascular control in hypertension - related left ventricular dysfunction. Hypertension 2009; 53: 205-9.Grassi G, Seravalle G, Quarti-Trevano F et al. Effects of hypertension and obesity on the sympathetic activation of heart failure patients. Hypertension 2003; 42: 873-7.Grassi G, Seravalle G, Quarti-Trevano F et al. Effects of hypertension and obesity on the sympathetic activation of heart failure patients. Hypertension 2003; 42: 873-7.Grassi G, Seravalle G, Dell’Oro R et al. Sympathetic and baroreflex function in hypertensive or heart failure patients with ventricular arrhythmias. J Hypertens 2004; 22: 1747-53.Grassi G, Seravalle G, Dell’Oro R et al. Sympathetic and baroreflex function in hypertensive or heart failure patients with ventricular arrhythmias. J Hypertens 2004; 22: 1747-53.Seravalle G, Volpe M, Ganz F et al. Neuroadrenergic profile in patients with resistant hypertension. J Hypertens 2011; 29: e141 (abstract).Seravalle G, Volpe M, Ganz F et al. Neuroadrenergic profile in patients with resistant hypertension. J Hypertens 2011; 29: e141 (abstract).Grassi G, Colombo M, Seravalle G et al. Dissociation between muscle and skin sympathetic nerve activity in essential hypertension, obesity, and congestive heart failure. Hypertension 1998; 31: 64-7.Grassi G, Colombo M, Seravalle G et al. Dissociation between muscle and skin sympathetic nerve activity in essential hypertension, obesity, and congestive heart failure. Hypertension 1998; 31: 64-7.Grassi G, Seravalle G, Brambilla G et al. Regional differences in sympathetic activation in lean and obese normotensive individuals with obstructive sleep apnoea. J Hypertens 2014; 32: 383-8.Grassi G, Seravalle G, Brambilla G et al. Regional differences in sympathetic activation in lean and obese normotensive individuals with obstructive sleep apnoea. J Hypertens 2014; 32: 383-8.Grassi G, Seravalle G, Arenare F et al. Behaviour of regional adrenergic outflow in mild - to - moderate renal failure. J Hypertens 2009; 27: 562-6.Grassi G, Seravalle G, Arenare F et al. Behaviour of regional adrenergic outflow in mild - to - moderate renal failure. J Hypertens 2009; 27: 562-6.Bevan R.D, Tsuru H. Functional and structural changes in the rabbit ear artery after sympathetic denervation. Circ Res 1981; 49: 478-85.Bevan R.D, Tsuru H. Functional and structural changes in the rabbit ear artery after sympathetic denervation. Circ Res 1981; 49: 478-85.Mangoni A.A, Mircoli L, Giannattasio C et al. Effect of sympathectomy on mechanical properties of common carotid and femoral arteries. Hypertension 1997; 30: 1085-8.Mangoni A.A, Mircoli L, Giannattasio C et al. Effect of sympathectomy on mechanical properties of common carotid and femoral arteries. Hypertension 1997; 30: 1085-8.Failla M, Grappiolo A, Emanuelli G et al. Sympathetic tone restrains arterial distensibility of healthy and atherosclerotic subjects. J Hypertens 1999; 17: 1117-23.Failla M, Grappiolo A, Emanuelli G et al. Sympathetic tone restrains arterial distensibility of healthy and atherosclerotic subjects. J Hypertens 1999; 17: 1117-23.Mancia G. Short - term and long - term blood pressure variability. In: Berbari A.E, Mancia G, eds. Special Issues in Hypertension. Milan: Springer, 2012: p. 91-102.Mancia G. Short - term and long - term blood pressure variability. In: Berbari A.E, Mancia G, eds. Special Issues in Hypertension. Milan: Springer, 2012: p. 91-102.Cohn J.N, Levine T.B, Olivari M.T et al. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 1984; 311: 819-23.Cohn J.N, Levine T.B, Olivari M.T et al. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 1984; 311: 819-23.Brunner-La Rocca H.P, Esler M.D, Jennings G.L, Kaye D.M. Effect of cardiac sympathetic nervous activity on mode of death in congestive heart failure. Eur Heart J 2001; 22: 1136-43.Brunner-La Rocca H.P, Esler M.D, Jennings G.L, Kaye D.M. Effect of cardiac sympathetic nervous activity on mode of death in congestive heart failure. Eur Heart J 2001; 22: 1136-43.Sander D, Winbeck K, Klingelhofer J et al. Prognostic relevance of pathological sympathetic activation after acute thromboembolic stroke. Neurology 2001; 57: 833-8.Sander D, Winbeck K, Klingelhofer J et al. Prognostic relevance of pathological sympathetic activation after acute thromboembolic stroke. Neurology 2001; 57: 833-8.Zoccali C, Mallamaci F, Parlongo S et al. Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end - stage renal disease. Circulation 2002; 105: 1354-9.Zoccali C, Mallamaci F, Parlongo S et al. Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end - stage renal disease. Circulation 2002; 105: 1354-9.Barretto A.C, Santos A.C, Munhoz R et al. Increased muscle sympathetic nerve activity predicts mortality in heart failure patients. Int J Cardiol 2009; 135: 302-7.Barretto A.C, Santos A.C, Munhoz R et al. Increased muscle sympathetic nerve activity predicts mortality in heart failure patients. Int J Cardiol 2009; 135: 302-7.Andreas S, Haarmann H, Klarner S et al. Increased sympathetic nerve activity in COPD is associated with morbidity and mortality. Lung 2014; 192: 235-41.Andreas S, Haarmann H, Klarner S et al. Increased sympathetic nerve activity in COPD is associated with morbidity and mortality. Lung 2014; 192: 235-41.Penne E.L, Neumann J, Klein I.H et al. Sympathetic hyperactivity and clinical outcome in chronic kidney disease during standard treatment. J Nephrol 2009; 22: 208-15.Penne E.L, Neumann J, Klein I.H et al. Sympathetic hyperactivity and clinical outcome in chronic kidney disease during standard treatment. J Nephrol 2009; 22: 208-15.Grassi G, Seravalle G, Stella M.L et al. Sympathoexcitatory responses to the acute blood pressure fall induced by central or peripheral antihypertensive drugs. Am J Hypertens 2000; 13: 29-34.Grassi G, Seravalle G, Stella M.L et al. Sympathoexcitatory responses to the acute blood pressure fall induced by central or peripheral antihypertensive drugs. Am J Hypertens 2000; 13: 29-34.Grassi G. Counteracting the sympathetic nervous system in essential hypertension. Curr Opin Nephrol Hypertens 2004; 13: 513-9.Grassi G. Counteracting the sympathetic nervous system in essential hypertension. Curr Opin Nephrol Hypertens 2004; 13: 513-9.Van Zwieten P. Beneficial interactions between pharmacological, pathophysiological and hypertension research. J Hypertens 2001; 19: 465-73.Van Zwieten P. Beneficial interactions between pharmacological, pathophysiological and hypertension research. J Hypertens 2001; 19: 465-73.Grassi G, Seravalle G, Calhoun D.A, Mancia G. Physical training and baroreceptor control of sympathetic nerve activity in humans. Hypertension 1994; 23: 294-301.Grassi G, Seravalle G, Calhoun D.A, Mancia G. Physical training and baroreceptor control of sympathetic nerve activity in humans. Hypertension 1994; 23: 294-301.Grassi G, Seravalle G, Colombo M et al. Body weight reduction, sympathetic nerve traffic, and arterial baroreflex in obese normotensive humans. Circulation 1998; 97: 2037-42.Grassi G, Seravalle G, Colombo M et al. Body weight reduction, sympathetic nerve traffic, and arterial baroreflex in obese normotensive humans. Circulation 1998; 97: 2037-42.Grassi G, Cattaneo B.M, Seravalle G et al. Baroreflex impairment by low sodium diet in mild or moderate essential hypertension. Hypertension 1997; 29: 802-7.Grassi G, Cattaneo B.M, Seravalle G et al. Baroreflex impairment by low sodium diet in mild or moderate essential hypertension. Hypertension 1997; 29: 802-7.Grassi G, Dell’Oro R, Seravalle G et al. Short - and long - term neuroadrenergic effects of moderate dietary sodium restriction in essential hypertension. Circulation 2002; 106: 1957-61.Grassi G, Dell’Oro R, Seravalle G et al. Short - and long - term neuroadrenergic effects of moderate dietary sodium restriction in essential hypertension. Circulation 2002; 106: 1957-61.Pal G.K, Adithan C, Dutta T.K et al. Preference for salt contributes to sympathovagal imbalance in the genesis of prehypertension. Eur J Clin Nutr 2013; 67: 586-91.Pal G.K, Adithan C, Dutta T.K et al. Preference for salt contributes to sympathovagal imbalance in the genesis of prehypertension. Eur J Clin Nutr 2013; 67: 586-91.Xu J, Hering D, Sata Y et al. Renal denervation: current implications and future perspectives. Clin Sci (Lond) 2014; 126: 41-53.Xu J, Hering D, Sata Y et al. Renal denervation: current implications and future perspectives. Clin Sci (Lond) 2014; 126: 41-53.Menne J, Jordan J, Linnenweber-Held S, Haller H. Resistant hypertension: baroreflex stimulation as a new tool. Nephrol Dial Transplant 2013; 28: 288-95.Menne J, Jordan J, Linnenweber-Held S, Haller H. Resistant hypertension: baroreflex stimulation as a new tool. Nephrol Dial Transplant 2013; 28: 288-95.Heusser K, Tank J, Engeli S et al. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients. Hypertension 2010; 55: 619-26.Heusser K, Tank J, Engeli S et al. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients. Hypertension 2010; 55: 619-26.Schmieder R.E, Redon J, Grassi G et al. ESH position paper: renal denervation - an interventional therapy of resistant hypertension. J Hypertens 2012; 30: 837-41.Schmieder R.E, Redon J, Grassi G et al. ESH position paper: renal denervation - an interventional therapy of resistant hypertension. J Hypertens 2012; 30: 837-41.Schlaich M.P, Schmieder R.E, Bakris G et al. International Expert Consensus statement: percutaneous transluminal denervation for the treatment of resistant hypertension. J Am Coll Cardiol 2013; 62: 2031-45.Schlaich M.P, Schmieder R.E, Bakris G et al. International Expert Consensus statement: percutaneous transluminal denervation for the treatment of resistant hypertension. J Am Coll Cardiol 2013; 62: 2031-45.Bhatt D.L, Kandzari D.E, O’Neill W.W et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370: 1393-401.Bhatt D.L, Kandzari D.E, O’Neill W.W et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370: 1393-401.Messerli F.H. Doxazosin and congestive heart failure. J Am Coll Cardiol 2001; 38: 1295-6.Messerli F.H. Doxazosin and congestive heart failure. J Am Coll Cardiol 2001; 38: 1295-6.Wiysonge C.S, Opie L.H. b-Blockers as initial therapy for hypertension. JAMA 2013; 310: 1851-2.Wiysonge C.S, Opie L.H. b-Blockers as initial therapy for hypertension. JAMA 2013; 310: 1851-2.Brinkmann J, Heusser K, Schmidt B.M et al. Catheter - based renal nerve ablation and centrally generated sympathetic activity in difficult - to - control hypertensive patients: prospective case series. Hypertension 2012; 60: 1485-90.Brinkmann J, Heusser K, Schmidt B.M et al. Catheter - based renal nerve ablation and centrally generated sympathetic activity in difficult - to - control hypertensive patients: prospective case series. Hypertension 2012; 60: 1485-90.ALLHAT Collaborative Research Group. Major cardiovascular events in hypertensive patients randomized to doxazosin vs. chlorthalidone: the antihypertensive and lipid - lowering treatment to prevent heart attack trial (ALLHAT). JAMA 2000; 283: 1967-75.ALLHAT Collaborative Research Group. Major cardiovascular events in hypertensive patients randomized to doxazosin vs. chlorthalidone: the antihypertensive and lipid - lowering treatment to prevent heart attack trial (ALLHAT). JAMA 2000; 283: 1967-75.Chen P.S, Tan A.Y. Autonomic nerve activity and atrial fibrillation. Heart Rhythm 2007; 4: S61-S64.Chen P.S, Tan A.Y. Autonomic nerve activity and atrial fibrillation. Heart Rhythm 2007; 4: S61-S64.Sharifov O.F, Fedorov V.V, Beloshapko G.G et al. Roles of adrenergic and cholinergic stimulation in spontaneous atrial fibrillation in dogs. J Am Coll Cardiol 2004; 43: 483-90.Sharifov O.F, Fedorov V.V, Beloshapko G.G et al. Roles of adrenergic and cholinergic stimulation in spontaneous atrial fibrillation in dogs. J Am Coll Cardiol 2004; 43: 483-90.Tan A.Y, Zhou S, Gholmieh G et al. Spontaneous autonomic nerve activity and paroxysmal atrial tachyarrhythmias (abstract). Heart Rhythm 2006; 3 (1S): S184.Tan A.Y, Zhou S, Gholmieh G et al. Spontaneous autonomic nerve activity and paroxysmal atrial tachyarrhythmias (abstract). Heart Rhythm 2006; 3 (1S): S184.Shen M.J, Choi E.K, Tan A.Y et al. Neural mechanisms of atrial arrhythmias. Nat Rev Cardiol 2011; 9: 30-9.Shen M.J, Choi E.K, Tan A.Y et al. Neural mechanisms of atrial arrhythmias. Nat Rev Cardiol 2011; 9: 30-9.Linz D, Mahfoud F, Schotten U et al. Renal sympathetic denervation suppresses postapneic blood pressure rises and atrial fibrillation in a model for sleep apnea. Hypertension 2012; 60: 172-8.Linz D, Mahfoud F, Schotten U et al. Renal sympathetic denervation suppresses postapneic blood pressure rises and atrial fibrillation in a model for sleep apnea. Hypertension 2012; 60: 172-8.Pokushalov E, Romanov A, Corbucci G et al. A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension. J Am Coll Cardiol 2012; 60: 1163-70.Pokushalov E, Romanov A, Corbucci G et al. A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension. J Am Coll Cardiol 2012; 60: 1163-70.Deftereos S, Giannopoulos G, Kossyvakis C et al. Effectiveness of moxonidine to reduce atrial fibrillation burden in hypertensive patients. Am J Cardiol 2013; 112: 684-7.Deftereos S, Giannopoulos G, Kossyvakis C et al. Effectiveness of moxonidine to reduce atrial fibrillation burden in hypertensive patients. Am J Cardiol 2013; 112: 684-7.Giannopoulos G, Kossyvakis C, Efremidis M et al. Central Sympathetic Inhibition to Reduce Post-Ablation Atrial Fibrillation Recurrences in Hypertensive Patients: A Randomized Controlled Study. Circulation 2014. Aug 21. [Epub ahead of print].Giannopoulos G, Kossyvakis C, Efremidis M et al. Central Sympathetic Inhibition to Reduce Post-Ablation Atrial Fibrillation Recurrences in Hypertensive Patients: A Randomized Controlled Study. Circulation 2014. Aug 21. [Epub ahead of print].

The authors declare that there are no conflicts of interest present.