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Sympathetic activity and hypertension

Sympathetic activity and hypertension
  • Cardiometabolic


26 February 2014



Course Introduction


This course describes the role of sympathetic activity in hypertension and in the development of target organ damage and also the effects of the anti-hypertensive drug treatment on such aspects. In hypertension an increase of sympathetic cardiovascular drive is often found, with repercussion both at central and peripheral level, from baroreflex modulation to the RAAS system activation. The different methods to assess the activation of sympathetic activity in hypertensive patients are so presented, from heart rate and catecholamine levels determination to microneurography, thus fully characterizing the clinical features of the subjects in view of the therapeutic options available. Several studies are summarized picturing the value of diverse antihypertensive drugs in reducing sympathetic activity, also considering the occurrence of related complications and comorbidities, and finally indications to properly implement patients’ treatment in clinical practice are provided.

Learning objectives

After having attended the course learners will have acquired better knowledge and improved their expertise in the management of hypertension, so being able to:

  • Evaluate the role of sympathetic activity in the pathophysiology of hypertension and in the development and progression of its target organ damage
  • Assess the level of activation of sympathetic activity in hypertensive patients by using first levels or advanced methods, including microneurography
  • Appraise the value of different antihypertensive drugs in reducing sympathetic activity thus properly implementing patient treatment in clinical practice

Target audience 

This course is intended for cardiologists, internists and also general practitioners dealing with the management of hypertension and its complications and comorbidities. 


This online course has been accredited by the European Board for Accreditation in Cardiology for 1 CME credit hour. 

Accreditation expiry date: 4 February 2016

Instructions for participation

There are no fees for participating in this online activity.

All participants must complete the registration form and log in to the website to access the activity.

As you progress through the course material there are several short true/false quizzes. These quizzes are not part of the course assessment but provide focus for you to reflect on the material covered in the previous section.

Once you have completed the activity, you should undertake the final assessment test comprising 10 questions. If you achieve a score of 80% or greater you will be able to download a CME certificate (European Board for Accreditation in Cardiology accreditation for 1 CME credit hour)


Professor Guido Grassi

University of Milano-Bicocca, Milan, Italy


Prof. Guido Grassi is Full Professor of Internal Medicine at the Clinica Medica of the University of Milano-Bicocca, S. Gerardo Hospital-Monza/Milano (Italy). He has been Director of the Post-Graduate School of Endocrinology (2001-2005) and he is since 2005 Director of the Post-Graduate School of Internal Medicine at the University of Milano-Bicocca. 

Member of the International Society of Hypertension, European Society of Hypertension, High Blood Pressure Council and Working Group on Hypertension and the Heart of the European Society of Cardiology. He has been Vice-Chairman (2002-2004) and then Chairman (2004-2006) of the Working Group “Hypertension and the Heart” of the European Society of Cardiology. He has been Treasurer and then Secretary of the Italian Society of Hypertension (2004-2007). In 2003-2007 he has received research grants from the Italian Society of Hypertension. In 2006- 2007 he has been member of the Task Force of the European Society of Hypertension/European Society of Cardiology for the 2007 Guidelines on Hypertension. In 2007 he has been appointed 'Wright Lecturer' at the Annual Meeting of the High Blood Pressure Council of Australia. In 2008 he has been elected in the Scientific Council of the International Society of Hypertension. In 2009 he has received the Bjorn Folkow Award and Lecture from the European Society of Hypertension.

His research areas include the pathophysiology, clinical pharmacology and treatment of hypertension, obesity and metabolic syndrome, cardiac arrhythmias and heart failure. He has published more than 350 original papers and reviews in major scientific international journals. He is Executive Editor of the Journal of Hypertension and member of the Editorial Board of Hypertension, Clinical Science, American Journal of Hypertension and Blood Pressure. He has been member of the Scientific Committee of the WHO/ISH Meetings held in 1991 and 1993, the IX-XII-XIV-XVI European Meeting on Hypertension and the Meeting of the International Society of Hypertension in Prague (2002) and in Berlin (2008).

Faculty disclosure

Disclosure of faculty relationships

EXCEMED adheres to guidelines of the European Accreditation Council for Continuing Medical Education (EACCME) and all other professional organizations, as applicable, which state that programs awarding continuing education credits must be balanced, independent, objective, and scientifically rigorous.

Investigative and other uses for pharmaceutical agents, medical devices, and other products (other than those uses indicated in approved product labeling/package insert for the product) may be presented in the program (which may reflect clinical experience, the professional literature or other clinical sources known to the presenter).

We ask all presenters to provide participants with information about relationships with pharmaceutical or medical equipment companies that may have relevance to their lectures. This policy is not intended to exclude faculty who have relationships with such companies; it is only intended to inform participants of any potential conflicts so participants may form their own judgments, based on full disclosure of the facts.

Further, all opinions and recommendations presented during the program and all program-related materials neither imply an endorsement, nor a recommendation, on the part of EXCEMED. All presentations solely represent the independent views of the presenters/authors.

The following faculty provided information regarding significant commercial relationships and/or discussions of investigational or non-EMEA/FDA approved (off-label) uses of drugs:

Guido Grassi declared no potential conflict of interest.