Vnitr Lek 2003, 49(1):61-65

[The sympathetic nervous system and insulin resistance].

H Rosolová: Centrum preventivní kardiologie II. interní kliniky Lékarské fakulty UK a FN, Plzen.

The submitted paper deals with the relationship of the sympathetic nervous system, metabolic syndrome of insulin resistance and cardiovascular risk. The author describes the structure and function of the sympathetic nervous system--the central part of the sympathetic nerve is in the hypothalamus and medulla oblongata. The hypothalamus combines vegetative control of the cardiovascular system and processes which influence the intermediary metabolism. This contributes to the explanation of the frequent incidence of metabolic disorders in subjects with arterial hypertension or ischaemic heart disease. The increased activity of the sympathetic nervous system is directly associated with the general cardiovascular mortality. Subjects with the metabolic syndrome of insulin resistance have a higher activity of the sympathetic nerve and thus a greater cardiovascular risk. The author describes the pathogenetic basis of this risk also in association with the sympathoadrenal system. The increased activity of the sympathetic nerve and insulin resistance can be successfully improved by a change of the lifestyle, i.e. non-smoking, a low-calorie diet, regular exercise and reduction of body weight. In addition cardiovascular risk can be reduced also pharmacologically, best by some antihypertensive drugs. In addition to classical antihypertensive drugs the author mentions agonists of imidazole receptors and their influence on the regulation of blood pressure and insulin resistance.