Prenatal Programming of Hypertension
Role of Sympathetic Response to Physical Stress
See related article, pp 180–186
The hemodynamic response to physical stress has been studied over the past decade, and it is considered an indicator of cardiovascular risk.1 The blood pressure response during acute exercise includes participation of the sympathetic nervous system, involving brain centers and peripheral reflexes.1 The sympathetic nervous system has a critical role in the regulation of blood pressure and in the cause of hypertension. Several reports from human and experimental models proposed that increased sympathetic activity is linked to hypertension and cardiovascular and renal diseases. Currently, there are 2 phase III clinical trials testing mechanical manipulations of the sympathetic nervous system as a treatment for hypertension. The SYMPLICITY HTN-3 Study is evaluating the safety and efficacy of renal denervation as a treatment for hypertension.2 The XR-1 Verification Study is assessing the safety and efficacy of carotid baroreflex activators in patients with drug-resistant hypertension.3 These clinical trials are the results of decades of research targeting the involvement of the sympathetic nervous system in the cause of hypertension. However, few studies are investigating the causes of dysfunction in this important regulatory system. What triggers the increases in sympathetic nervous system activity is still unclear.
The effects of adverse environment, such as poor nutrition …