Sympathetic Nervous System and Atherosclerosis

Abstract

Atherosclerosis is characterized by the narrowing of the arterial lumen due to subendothelial lipid accumulation, with hypercholesterolemia being a major risk factor. Despite the recent advances in effective lipid-lowering therapies, atherosclerosis remains the leading cause of mortality globally, highlighting the need for additional therapeutic strategies. Accumulating evidence suggests that the sympathetic nervous system plays an important role in atherosclerosis. In this article, we reviewed the sympathetic innervation in the vasculature, norepinephrine synthesis and metabolism, sympathetic activity measurement, and common signaling pathways of sympathetic activation. The focus of this paper was to review the effectiveness of pharmacological antagonists or agonists of adrenoceptors (α1, α2, β1, β2, and β3) and renal denervation on atherosclerosis. All five types of adrenoceptors are present in arterial blood vessels. α1 blockers inhibit atherosclerosis but increase the risk of heart failure while α2 agonism may protect against atherosclerosis and newer generations of β blockers and β3 agonists are promising therapies against atherosclerosis; however, new randomized controlled trials are warranted to investigate the effectiveness of these therapies in atherosclerosis inhibition and cardiovascular risk reduction in the future. The role of renal denervation in atherosclerosis inhibition in humans is yet to be established.

Autonomic Function in Obese Children and Adolescents: Systematic Review and Meta-Analysis

“…4 Baseline assessment. 5 Comparability of cohorts based on the design or analysis. 6 Ass ment of outcome.…”

“…Regarding sympathetic activity, such information would be of pathophysiologic and clinical relevance, based on recent evidence suggesting a key role of the sympathetic nervous system in enhancing the inflammatory process and, thereby, atherosclerosis [35]. The underlying mechanisms are currently under active investigation, aiming at the advent of new therapeutic options [5].…”

“…Moreover, a recent meta-analysis of studies examining weight changes revealed higher sympathetic and lower vagal activity accompanying weight gain, which were reversed after weight loss [4]. These observations carry pathophysiologic and therapeutic implications, as alterations in both autonomic arms have been linked with the progression of atherosclerosis in adult populations [5,6]. However, it remains unclear whether this process is active during the early stages of atheromatous plaque formation.…”

“…Ascertainment of exposure 4. Baseline assessment 5. Comparability of cohorts based on the design or analysis 6.…”

Autonomic Function in Obese Children and Adolescents: Systematic Review and Meta-Analysis

“…Newcastle-Ottawa quality scale for the included studies. 7 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 follow-up (2) 8 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 N/A 9 Score 1 Representativeness of the exposed cohort, 2 Selection of the non-exposed cohort, 3 Ascertainment of exposure, 4 Baseline assessment, 5 Comparability of cohorts on the basis of the design or analysis, 6 Assessment of outcome, 7 Was follow-up long enough for outcomes to occur, 8 Adequacy of follow-up. 9 Non-applicable (N/A), as none of the studies included follow-up.…”