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1556685 
Journal Article 
Sympathetic Nervous System Overactivity and Its Role in the Development of Cardiovascular Disease 
Malpas, SC 
2010 
1 
Physiological Reviews
ISSN: 0031-9333
EISSN: 1522-1210 
90 
2 
513-557 
20393193 
WOS:000276672300004 
Malpas SC. Sympathetic Nervous System Overactivity and Its
Role in the Development of Cardiovascular Disease. Physiol Rev 90: 513-557, 2010;
doi:10.1152/physrev.00007.2009.-This review examines how the sympathetic nervous system plays a
major role in the regulation of cardiovascular function over multiple time scales. This is
achieved through differential regulation of sympathetic outflow to a variety of organs. This
differential control is a product of the topographical organization of the central nervous system
and a myriad of afferent inputs. Together this organization produces sympathetic responses
tailored to match stimuli. The long-term control of sympathetic nerve activity (SNA) is an area
of considerable interest and involves a variety of mediators acting in a quite distinct fashion.
These mediators include arterial baroreflexes, angiotensin II, blood volume and osmolarity, and a
host of humoral factors. A key feature of many cardiovascular diseases is increased SNA. However,
rather than there being a generalized increase in SNA, it is organ specific, in particular to the
heart and kidneys. These increases in regional SNA are associated with increased mortality.
Understanding the regulation of organ-specific SNA is likely to offer new targets for drug
therapy. There is a need for the research community to develop better animal models and
technologies that reflect the disease progression seen in humans. A particular focus is required
on models in which SNA is chronically elevated.