Metabolic syndrome is associated with adverse health outcomes and is a growing problem worldwide. Although efforts to harmonize the definition of metabolic syndrome have helped to better understand the prevalence and the adverse outcomes associated with this disorder on a global scale, the mechanisms underpinning the metabolic changes that define it are incompletely understood.

Accumulating evidence from laboratory and human studies suggests that activation of the sympathetic nervous system has an important role in metabolic syndrome. Indeed, treatment strategies commonly recommended for patients with metabolic syndrome, such as improving diet and exercise to induce weight loss, are associated with sympathetic inhibition. Pharmacological and device-based approaches to target the activation of the sympathetic nervous system directly are available and have provided evidence to support the important part played by sympathetic regulation, particularly for blood pressure and glucose control. Preliminary evidence is encouraging, but whether therapeutically targeting sympathetic overactivity could help to prevent or manage metabolic diseases and attenuate their adverse outcomes remains to be determined.

The aim of this Special Issue is to collate original research and review articles in this field.

Potential topics include but are not limited to the following:

• Targeting the sympathetic nervous system in hypertension
• Sympathetic activation and target organ damage in hypertension
• The sympathetic nervous system and metabolic syndrome
• The sympathetic nervous system and diabetes mellitus
• The sympathetic nervous system and fatty liver disease associated with metabolic dysregulation (MAFLD)
• The sympathetic nervous system and the gut microbiome
• Novel biomarkers of the sympathetic nervous system
• Use of artificial intelligence in risk stratification use in sympathetic markers
• Hormones of the sympathetic nervous system