Sympathetic Activation in Hypertension and in Hypertension-Related Metabolic Disease

Cardiometabolic diseases, such as hypertension, obesity, diabetes and metabolic syndrome, are characterized by well known abnormalities in the hemodynamic profile. Only in recent years, however, evidence has been collected that cardiometabolic diseases are also characterized by neuroadrenergic alterations, the most important being the sympathetic overactivity. The neuroadrenergic abnormality 1) occurs early in the clinical course of the hypertensive and metabolic diseases, 2) follows the blood pressure elevation and 3) is paralleled by marked metabolic abnormalities, such as hyperinsulinemia, hyperleptinemia and insulin resistance. These neuroametabolic changes can be favourably affected both by non pharmacological and pharmacological interventions.