Comments on Point:Counterpoint: The dominant contributor to systemic hypertension: Chronic activation of the sympathetic nervous system vs. Activation of the intrarenal renin-angiotensin system. Activation of the sympathetic nervous system is the dominant contributor to systemic hypertension.

摘要

We agree with Dr. Navar that the dominant mechanism responsible for hypertension calls to mind the poem "The Blind Men and the Elephant" (6). However, we take this opportunity to offer some accumulated evidences from our studies that favor the idea that sympathetic nerve activity is relevant and possibly a dominant mechanism underlying essential hypertension (2). Cardiac sympathetic tonus is augmented in spontaneously hypertensive rats (3) and muscle sympathetic nerve activity (MSNA) is increased in never-treated hypertensive patients (4). Also, nonpharmacological therapy based on regular exercise caused reductions in cardiac sympathetic tonus, MSNA, and consequently, blood pressure (3, 4). Moreover, the absolute changes in MSNA and the absolute changes in blood pressure were significantly associated (4).