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Neural Mechanisms

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Hypertension and Heart Failure

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

The last four decades of extensive investigations have revealed that sympathetic nervous system plays a critical pathogenic role in blood pressure elevation and sustained hypertension. The regional noradrenaline spillover technique was a major breakthrough in assessing human sympathetic activation and indicated that particularly two organs – the heart and the kidney are pivotal in human hypertension and heart failure. Enhanced sympathetic activation has been directly linked to hypertension mediated organ damage and associated cardiovascular and renal complications. Notably, in heart failure patients, high cardiac and renal sympathetic tone contributes to the progression of disease and mortality. There are now preliminary data to suggest that therapeutic approaches such as renal denervation, baroreflex activation therapy and carotid body removal can modulate directly the neural mechanisms underlying the pathophysiology of hypertension and heart failure.

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Authors and Affiliations

  1. Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland

    Dagmara Hering & Krzysztof Narkiewicz

  2. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia

    Dagmara Hering

  3. Istituto Auxologico Italiano IRCCS Ospedale San Luca, Milan, Italy

    Gino Seravalle

  4. Clinica Medica, Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy

    Guido Grassi

  5. IRCCS Multimedica, Sesto San Giovanni, Milan, Italy

    Guido Grassi

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  1. Dagmara Hering
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  2. Gino Seravalle
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  3. Guido Grassi
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  4. Krzysztof Narkiewicz
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Correspondence to Dagmara Hering .

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Editors and Affiliations

  1. Carol Davila University of Medicine and Pharmacy Bucharest and Cardiology Department, Emergency Clinical Hospital, Bucharest, Romania

    Maria Dorobantu

  2. University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia  & Guido Grassi  & 

  3. Department of Pharmacology, Toxicology and Clinical Psychopharmacology Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Victor Voicu

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Hering, D., Seravalle, G., Grassi, G., Narkiewicz, K. (2019). Neural Mechanisms. In: Dorobantu, M., Mancia, G., Grassi, G., Voicu, V. (eds) Hypertension and Heart Failure. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-93320-7_5

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