Skip to main content
SpringerLink
Log in

Sympathetic Nervous System, Hypertension, Obesity and Metabolic Syndrome

  • Review Article
  • Published:
High Blood Pressure & Cardiovascular Prevention Aims and scope Submit manuscript

Abstract

Experimental and clinical studies have clearly shown the role of the sympathetic nervous system in the pathophysiology of several cardiovascular and non-cardiovascular diseases. This short review will be aimed at focusing and discussing the new information collected on two specific clinical conditions such as obesity and metabolic syndrome. The paper will briefly describe the four main mechanisms that represent the common link between these two pathophysiological conditions and that through the sympathetic nervous system contribute to increase the cardiovascular risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ncep-Atp III. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III). J Am Med Ass. 2001;285:1486–2497.

    Google Scholar 

  2. Schillaci G, Pirro M, Vaudo G, Gemelli F, Marchesi S, Porcellati C, Mannarino E. Prognostic value of the metabolic syndrome in essential hypertension. J Am Coll Cardiol. 2004;43:1817–22.

    Article  PubMed  Google Scholar 

  3. Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138:24–32.

    Article  PubMed  Google Scholar 

  4. Grassi G, Seravalle G, Dell’Oro R, Quarti Trevano F, Bombelli M, Scopelliti F, Facchini A, Mancia G. Comparative effects of candesartan and hydrochlorothiazide on blood pressure, insulin sensitivity, and sympathetic drive in obese hypertensive individuals: results of the CROSS study. J Hypertens. 2003;21:1761–9.

    Article  CAS  PubMed  Google Scholar 

  5. Schlaich MP, Kaye DM, Lambert E, Sommerville M, Socratous F, Esler MD. Relation between cardiac sympathetic activity and hypertensive left ventricular hypertrophy. Circulation. 2003;108:560–5.

    Article  PubMed  Google Scholar 

  6. Kaplan NM. The deadly quartet. Upper body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med. 1989;149:1514–20.

    Article  CAS  PubMed  Google Scholar 

  7. Reaven GM. Banting Lecture. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–607.

    Article  CAS  PubMed  Google Scholar 

  8. Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, Gonzales-Sanchez JL, Seclen S, Villena A, Gonzales-Villapando C, Williams K, Haffner SM. Geographic variations of the International Diabetes Federation and the National Cholesterol Education Program-Adult Treatment Panel III definitions of metabolic syndrome in non diabetic subjects. Diabetes Care. 2006;29:685–91.

    Article  PubMed  Google Scholar 

  9. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. Metabolic syndrome: prevalence and association risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med. 2003;163:427–36.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Poyrazoglu S, Bas F, Darendeliler F. Metabolic syndrome in young people. Curr Opin Endocrinol Diabetes Obes. 2014;21:56–63.

  11. Alberti KG, Zimmet P, Shaw J, For the IDF Epidemiology Task Force Consensus Group. Metabolic syndrome: a new world-wide definition. Lancet. 2005;366:1059–1062.

  12. Esposito K, Giugliano D. The metabolic syndrome and inflammation: association or causation? Nutr Metab Cardiovasc Dis. 2004;14:228–32.

    Article  CAS  PubMed  Google Scholar 

  13. Ritchie SA, Connell JM. The link between abdominal obesity, metabolic syndrome and cardiovascular disease. Nutr Metab Cardiovasc Dis. 2007;17:319–26.

    Article  CAS  PubMed  Google Scholar 

  14. Siani A, Strazzullo P. Tackling the genetic bases of metabolic syndrome: a realistic objective? Nutr Metab Cardiovasc Dis. 2006;16:309–12.

    Article  PubMed  Google Scholar 

  15. Iribarren C, Go AS, Husson G, Sidney S, Fair JM, Quertermous T, Hlatky MA, Fortmann SP. Metabolic syndrome and early-onset coronary artery disease. Is the whole greater than its parts? J Am Coll Cardiol. 2006;48:1800–7.

    Article  CAS  PubMed  Google Scholar 

  16. Reaven GM, Lithell H, Landsberg L. Hypertension and associated metabolic abnormalities—the role of insulin resistance and the sympathoadrenal system. N Engl J Med. 1996;334:374–81.

    Article  CAS  PubMed  Google Scholar 

  17. Landsberg L. Diet, obesity and hypertension: an hypothesis involving the sympathetic nervous system, and adaptive thermogenesis. Q J Med. 1986;61:1081–90.

    CAS  PubMed  Google Scholar 

  18. Young JB, Macdonald IA. Sympathoadrenal activity in human obesity: heterogeneity of findings since 1980. Int J Obes Relat Metab Disord. 1992;16:959–67.

    CAS  PubMed  Google Scholar 

  19. Troisi RJ, Weiss ST, Parker DR, Sparrow D, Young JB, Landsberg L. Relation of obesity and diet to sympathetic nervous system activity. Hypertension. 1991;17:669–77.

    Article  CAS  PubMed  Google Scholar 

  20. Grassi G, Seravalle G, Cattaneo BM, Bolla GB, Lanfranchi A, Colombo M, Giannattasio C, Brunani A, Cavagnini F, Mancia G. Sympathetic activation in obese normotensive subjects. Hypertension. 1995;25:560–3.

    Article  CAS  PubMed  Google Scholar 

  21. Vaz M, Jennings G, Turner A, Cox H, Lambert G, Esler M. Regional sympathetic nervous activity and oxygen consumption in obese normotensive human subjects. Circulation. 1997;96:3423–9.

    Article  CAS  PubMed  Google Scholar 

  22. Grassi G, Dell’Oro R, Facchini A, Quarti Trevano F, Bolla GB, Mancia G. Effects of central and peripheral body fat distribution on sympathetic and baroreflex function in obese normotensive. J Hypertens. 2004;22:2363–9.

    Article  CAS  PubMed  Google Scholar 

  23. Alvarez GE, Ballard TP, Beske SD, Davy KP. Subcutaneous obesity is not associated with sympathetic neural activation. Am J Physiol. 2004;287:H414–8.

    CAS  Google Scholar 

  24. Huggett RJ, Burns J, Makintosj AF, Mary DA. Sympathetic neural activation in non diabetic metabolic syndrome and its further augmentation by hypertension. Hypertension. 2004;44:847–52.

    Article  CAS  PubMed  Google Scholar 

  25. Grassi G, Dell’Oro R, Quarti Trevano F, Scopelliti F, Seravalle G, Paleari F, Gamba PL, Mancia G. Neuroadrenergic and reflex abnormalities in patients with metabolic syndrome. Diabetologia. 2005;48:1359–65.

    Article  CAS  PubMed  Google Scholar 

  26. Grassi G, Seravalle G, Quarti Trevano F, Scopelliti F, Dell’Oro R, Bolla GB, Mancia G. Excessive sympathetic activation in heart failure with obesity and metabolic syndrome: characteristics and mechanisms. Hypertension. 2007;49:535–41.

    Article  CAS  PubMed  Google Scholar 

  27. Vollenweider P, Tappy L, Randin D, Schneiter P, Jequier E, Nicod P, Scherrer U. Differential effects of hyperinsulinemia and carbohydrate metabolism on sympathetic nerve activity and muscle blood flow in humans. J Clin Invest. 1993;92:147–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Gudbjornsdottir S, Friberg P, Elam M, Attvall S, Lonnroth P, Wallin BG. The effects of metformin and insulin on sympathetic nerve activity, norepinehrine spillover and blood pressure in obese, insulin resistant, normoglycemic, hypertensive men. Blood press. 1994;3:394–403.

    Article  CAS  PubMed  Google Scholar 

  29. Shlaich MP, Lambert E, Kaye DM, Krozowski Z, Campbell DJ, Lambert G, Hastings J, Aggarwal A, Esler MD. Sympathetic augmentation in hypertension: role of nerve firing, norepinephrine uptake, and angiotensin neuromodulation. Hypertension. 2004;43:169–75.

    Article  Google Scholar 

  30. Jamerson KA, Julius S, Gudbrandsson T, Andersson O, Brandt DO. Reflex sympathetic activation induces acute insulin resistance in the human forearm. Hypertension. 1993;21:618–23.

    Article  CAS  PubMed  Google Scholar 

  31. Eikelis N, Lambert G, Wiesner G, Kaye D, Schlaich M, Morris M, Hastings J, Socratous F, Esler M. Extra-adipocyte leptin release in human obesity and its relation to sympathoadrenal function. Am J Physiol Endocrinol Metab. 2004;286:E744–52.

    Article  CAS  PubMed  Google Scholar 

  32. Straznicky NE, Lambert E, Lambert GW, Masuo K, Esler MD, Nestel PJ. Effects of dietary weight loss on sympathetic activity and cardiac risk factors associated with the metabolic syndrome. J Clin Endocrinol Metab. 2005;90:5998–6005.

    Article  CAS  PubMed  Google Scholar 

  33. Zha JM, Di WJ, Zhu T, Xie Y, Yu J, Liu J, Chen P, Ding G. Comparison of gene transcription between subcutaneous and visceral adipose tissue in Chinese Adults. Endocr J. 2009;56:935–44.

    Article  CAS  PubMed  Google Scholar 

  34. Mark AL. Selective leptin resistance revisited. Am J Physiol Endocrinol Metab. 2013;305:R566–81.

    CAS  Google Scholar 

  35. Grassi G, Seravalle G, Colombo M, Bolla GB, Cattaneo BM, Cavagnini F, Mancia G. Body weight reduction, sympathetic nerve traffic and arterial baroreflex in obese normotensive humans. Circulation. 1998;97:2037–42.

    Article  CAS  PubMed  Google Scholar 

  36. Narkiewicz K, van de Borne PJ, Pesek CA, Dyken ME, Montano N, Somers VK. Selective potentiation of peripheral chemoreflex sensitivity in obstructive sleep apnea. Circulation. 1999;99:1183–9.

    Article  CAS  PubMed  Google Scholar 

  37. Grassi G, Facchini A, Quarti Trevano F, Dell’Oro R, Arenare F, Tana F, Bolla GB, Monzani A, Robuschi M, Mancia G. Obstructive sleep apnea-dependent and -independent adrenergic activation in obesity. Hypertension. 2005;46:321–5.

    Article  CAS  PubMed  Google Scholar 

  38. Reid IA. Interactions between ANG II, sympathetic nervous system, and baroreceptor reflexes in regulation of blood pressure. Am J Physiol Endo Metab. 1992;262:E763–78.

    CAS  Google Scholar 

  39. Miyajima E, Shigemasa T, Yamada Y, Tochikubo O, Ishii M. Angiotensin II blunts, while angiotensin converting enzyme inhibitor augments, reflex sympathetic inhibition in humans. Clin Exper Pharmacol Physiol. 1999;26:797–802.

    Article  CAS  Google Scholar 

  40. Engeli S, Negrel R, Sharma AM. Physiology and pathophysiology of the adipose tissue renin-angiotensin system. Hypertension. 2000;35:1270–7.

    Article  CAS  PubMed  Google Scholar 

  41. Prabhakar NR, Fields RD, Baker T, Fletcher EC. Intermittent hypoxia: cell to system. Am J Physiol. 2001;281:L524–8.

    CAS  Google Scholar 

  42. Belaidi E, Joyeux-Faure M, Ribout C, Launois SH, Levy P, Godin Ribout D. Major role for hypoxia inducible factor-1 and the endothelin system in promoting myocardial infarction and hypertension in animal model of obstructive sleep apnea. J Am Coll Cardiol. 2009;53:1309–17.

    Article  CAS  PubMed  Google Scholar 

  43. Guzik TJ, Hoch NE, Brown KA, McCann LA, Rahman A, Dikalov S, Goronzy J, Weyand C, Harrison DG. Role of the T cell in the genesis of angiotensin II induced hypertension and vascular dysfunction. J Exp Med. 2007;204:2449–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Bruno RM, Ghiadoni L, Seravalle G, Dell’Oro R, Taddei S, Grassi G. Sympathetic regulation of vascular function in health and disease. Front Physiol. 2012;3:284.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiology Department, S. Luca Hospital, Istituto Auxologico Italiano, Piazza Brescia 20, 20149, Milan, Italy

    Gino Seravalle

  2. Clinica Medica, University Milano Bicocca, Monza, Italy

    Guido Grassi

  3. IRCCS Multimedica, Sesto San Giovanni, Milan, Italy

    Guido Grassi

Authors
  1. Gino Seravalle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guido Grassi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gino Seravalle.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seravalle, G., Grassi, G. Sympathetic Nervous System, Hypertension, Obesity and Metabolic Syndrome. High Blood Press Cardiovasc Prev 23, 175–179 (2016). https://doi.org/10.1007/s40292-016-0137-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40292-016-0137-4

Keywords

Search

Navigation