Sympathetic Overactivation in Cardiometabolic Hypertension: An Emerging Therapeutic Target

The pivotal role of sympathetic overactivity in hypertension has been relatively overlooked. For optimal blood pressure (BP) control, treating both the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS) is crucial given the tight interplay between these systems. Despite growing expert consensus recognising the importance of SNS modulation, international recommendations still rarely include SNS-targeting approaches beyond beta-blockers—especially those that reduce central sympathetic outflow—highlighting an important area for further guideline development and clinical optimisation. Greater clinical awareness and consideration of SNS-focused strategies could help close persistent gaps in BP control.