Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension.

TO THE EDITOR: I thank my friends, colleagues, and opponents for their thoughtful submissions (see Ref. 1), which capture the diversity of views concerning the pathophysiological mechanisms of essential hypertension. Many seem to have lodged an each-way bet, invoking parallel sympathetic nervous system and renin-angiotensin system origins. A few seemed to think the question was a silly one and that Dr. Navar and I were rather foolish to attempt to answer it. I do stand by my position that the sympathetic nervous system is the prime mover. Harsh empirical facts can sometimes cancel out elaborate and plausible theories. It will be interesting to watch whether the realities of blood pressure reduction with catheter-based renal sympathetic denervation in hypertensive patients will over time shift some opinions.