The autonomic nervous system and renal physiology
نویسندگان
چکیده
Research in resistant hypertension has again focused on autonomic nervous system denervation - 50 years after it had been stopped due to postural hypotension and availability of newer drugs. These (ganglionic blockers) drugs have all been similarly stopped, due to postural hypotension and yet newer antihypertensive agents. Recent demonstration of the feasibility of limited regional transcatheter sympathetic denervation has excited clinicians due to potential therapeutic implications. Standard use of ambulatory blood pressure recording equipment may alter our understanding of the diagnosis, potential treatment strategies, and health care outcomes - when faced with patients whose office blood pressure remains in the hypertensive range - while under treatment with three antihypertensive drugs at the highest tolerable doses, plus a diuretic. We review herein clinical relationships between autonomic function, resistant hypertension, current treatment strategies, and reflect upon the possibility of changes in our approach to resistant hypertension.
منابع مشابه
Assessment of autonomic nervous system function in patients with non-alcoholic cirrhosis
Automatic dysfunction may contribute to the hemodynamic disturbances in cirrhosis. Tests of autonomic function were performed in 31 patients with non-alcoholic cirrhosis and 30 healthy subjects. Patients were divided into 3 groups according to child- Pugh,s classification ( A.B.C). The patients with moderate and severe cirrhosis( child B,C) had significant parasympathetic disturbance ( in the v...
متن کاملPhysiology in perspective: The Wisdom of the Body. Neural control of the kidney.
Cannon equated the fluid matrix of the body with Bernard's concept of the internal environment and emphasized the importance of "the safe-guarding of an effective fluid matrix." He further emphasized the important role of the autonomic nervous system in the establishment and maintenance of homeostasis in the internal environment. This year's Cannon Lecture discusses the important role of the re...
متن کاملSystemic hemodynamic responses to chronic angiotensin II infusion into the renal artery of dogs.
Chronic intrarenal infusion of angiotensin II (0.5 ng ⋅ kg-1 ⋅ min-1) in dogs increases arterial pressure. In the present study we determined whether this was associated with changes in cardiac output or in total peripheral resistance. Mean arterial pressure did not change initially but was significantly increased over days 14- 28 of the infusion period (+6 ± 2 mmHg), as was total peripheral re...
متن کاملPathophysiology of hypertension in blacks and whites. A review of the basis of racial blood pressure differences.
Differences in blood pressure between blacks and whites in the United States are now well documented. The causes of these differences remain speculative. Genetic factors, personal characteristics, renal physiology, endocrine factors, autonomic nervous system function, cardiac function and various environmental factors are examined in the present review as potential determinants of racial blood ...
متن کاملبررسی الکتروفیزیولوژیک سیستم عصبی خودکار در بیماران دیابتی بیمارستان شریعتی، 1381
Autonomic nervous system dysfunction in diabetics can occur apart from peripheral sensorimotor polyneuropathy and sometimes leads to complaints which may be diagnosed by electrodiagnostic methods. Moreover glycemic control of these patients may prevent such a complications.Materials and Methods: 30 diabetic patients were compared to the same number of age and sex-matched controls regarding to e...
متن کاملInvited Review THE WALTER B. CANNON MEMORIAL AWARD LECTURE Physiology in perspective: The Wisdom of the Body. Neural control of the kidney
DiBona, Gerald F. Physiology in perspective: The Wisdom of the Body. Neural control of the kidney. The Walter B. Cannon Memorial Award Lecture. Am J Physiol Regul Integr Comp Physiol 289: R633–R641, 2005; 10.1152/ajpregu.00258.2005— Cannon equated the fluid matrix of the body with Bernard’s concept of the internal environment and emphasized the importance of “the safe-guarding of an effective f...
متن کامل