Causes and consequences of sympathoexcitation across the lifespan: Physiological or pathological?

The role of the sympathetic nervous system in buffering acute changes in blood pressure is well established. More recently, attention has turned to the importance of sympathetic activity in chronic regulation of blood pressure (Lohmeier & Iliescu, 2015) and the potential risks associated with excess sympathoexcitation. Elevated sympathetic nerve activity is observed in hypertension (Grassi et al., 2018), heart failure (Grassi et al., 2021), obesity (Alvarez et al., 2002) and metabolic syndrome (Quarti Trevano et al., 2020). Indeed, sympathoexcitation is considered (by some) to be causative in hypertension (Esler et al., 2010; Koeners et al., 2016). As such, the mechanisms driving sympathoexcitation in various patient populations are the focus of ongoing research.