Neurogenic factors in human hypertension: Mechanism or myth?

Abstract

The processes which initiate the elevation of blood pressure in most patients with hypertension are unknown. Considered here is whether neurogenic influences, especially those related to the sympathetic nervous system, are pathogenic in primary hypertension. Reviewed are the observations of autonomic function in normotensive and hypertensive man, especially those related to adrenergic neurotransmitter metabolism; altered catecholamine metabolism in hypertensive patients, and the correlations with the status of their cardiovascular and renin-angiotensin system; abnormal catecholamine metabolism in tissues of animal models with hypertension; and tissue catecholamine metabolism in man with increased and normal blood pressure. The term neurogenic, as used herein, refers to the central and peripheral aspects of the sympathetic nervous system. For other aspects of neurogenic hypertension, the reader is referred to the excellent text by Dickinson [1].