Hypertension: A problem of organ blood flow supply-demand mismatch

Maarten P. Koeners*, Kirsty E. Lewis, Anthony P. Ford, Julian F. Paton

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

9 Citations (Scopus)
225 Downloads (Pure)


This review introduces a new hypothesis that sympathetically mediated hypertensive diseases are caused, in the most part, by the activation of visceral afferent systems that are connected to neural circuits generating sympathetic activity. We consider how organ hypoperfusion and blood flow supply-demand mismatch might lead to both sensory hyper-reflexia and aberrant afferent tonicity. We discuss how this may drive sympatho-excitatory-positive feedback and extend across multiple organs initiating, or at least amplifying, sympathetic hyperactivity. The latter, in turn, compounds the challenge to sufficient organ blood flow through heightened vasoconstriction that both maintains and exacerbates hypertension.

Original languageEnglish
Pages (from-to)339-349
Number of pages11
JournalFuture Cardiology
Issue number3
Publication statusPublished - 1 May 2016


  • hypertension
  • hypoperfusion
  • organ blood flow
  • sympathetic hyperactivity
  • visceral afferent hyper-reflexia

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