Role of the sympathetic nervous system in cardiovascular disease

Abstract

The sympathetic nervous system is pivotal in both circulatory and metabolic control. While acute activation of the sympathetic nervous system is important during regular daily activities in order to maintain homeostasis or in times of stress in order to initiate a fight or flight response, chronic activation of the sympathetic nervous system is associated with disease development and end-organ dysfunction. Of particular importance is the role of the sympathetic nervous system in the initiation and maintenance of hypertension and the development of left ventricular hypertrophy, diastolic dysfunction, and insulin resistance. Given the undoubted role of the sympathetic nervous system in generating cardio-metabolic illness, inhibition of the sympathetic nervous system seems a logical choice in order to alleviate disease burden associated with these conditions. Lifestyle changes involving diet, exercise, and cognitive-based therapies as well as pharmacological and device-based interventions directly targeting the sympathetic nervous system are likely to be of benefit.