Hypertension affects over 25 % of the population with the incidence continuing to rise, due in part to the growing obesity epidemic. Chronic elevations in sympathetic nerve activity (SNA) are a hallmark of the disease and contribute to elevations in blood pressure through influences on the vasculature, kidney, and heart (i.e., neurogenic hypertension). In this regard, a number of central nervous system mechanisms and neural pathways have emerged as crucial in chronically elevating SNA. However, it is important to consider that "sympathetic signatures" are present, with differential increases in SNA to regional organs that are dependent upon the disease progression. Here, we discuss recent findings on the central nervous system mechanisms and autonomic regulatory networks involved in neurogenic hypertension, in both non-obesity- and obesity-associated hypertension, with an emphasis on angiotensin-II, salt, oxidative and endoplasmic reticulum stress, inflammation, and the adipokine leptin.
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http://dx.doi.org/10.1007/s11906-016-0635-8 | DOI Listing |
J Clin Med
January 2025
Department of Medical Specialities I, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Neurogenic orthostatic hypotension (NOH) is a significant non-motor manifestation of Parkinson's disease (PD), that substantially affects patient disability and has a powerful impact on the quality of life of PD patients, while also contributing to increased healthcare costs. This narrative review aims to summarize key insights into the diagnosis and management of NOH in individuals with PD. For diagnosing NOH, a recently introduced and valuable metric is the ΔHr/ΔSBP index.
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Internal Medicine, Merit Health Wesley, Hattiesburg, USA.
Anterior cord syndrome is a rare yet critical neurological condition that poses significant challenges in clinical management. We present the case of a 71-year-old male with a medical history of hypertension, uncontrolled type II diabetes mellitus, hypothyroidism, and end-stage renal disease requiring dialysis who presented to the emergency department with complaints of chills, back pain, abdominal pain, and vomiting episodes. Based on the severity of the patient's illness, it was decided that inpatient admission would be best.
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December 2024
Internal Medicine, Meharry Medical College, Nashville, USA.
Diabetic cardiac autonomic neuropathy (CAN) is caused by damage to the autonomic nerve fibers that innervate the heart and blood vessels, leading to abnormalities in heart rate control and vascular dynamics. CAN encompasses symptoms such as exercise intolerance, orthostatic hypotension, cardiac denervation syndrome, and nocturnal hypertension. Neurogenic orthostatic hypotension (nOH), resulting from severe diabetic CAN, can cause symptomatic orthostatic hypotension.
View Article and Find Full Text PDFBiomed Pharmacother
January 2025
Department of Pharmaceutical Sciences, North Dakota State University, Fargo, ND 58102, United States. Electronic address:
Neurogenic hypertension (NH) is characterized by heightened sympathetic activity mediated by angiotensin II in specific brain areas including the paraventricular nucleus and circumventricular organs. While strategies targeting sympathetic activity have shown effectiveness in managing NH, their invasive nature hinders their widespread clinical adoption. Conversely, nose-to-brain drug delivery is emerging as a promising approach to access the brain with reduced invasiveness.
View Article and Find Full Text PDFAm J Physiol Regul Integr Comp Physiol
February 2025
Department of Surgery, Medical School, University of Minnesota, Minneapolis, Minnesota, United States.
The organum vasculosum of the lamina terminalis (OVLT) is a forebrain circumventricular organ that modulates central autonomic control of arterial pressure and body fluid homeostasis. It has been implicated in the pathogenesis of rat models of hypertension that are driven by increased salt intake since OVLT lesion (OVLTx) attenuates both the DOCA-salt and angiotensin II-salt models. However, its contribution to the development of hypertension that is not salt-dependent, such as the 2 kidney, 1 clip (2K1C) renovascular model, is not clear.
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