| Obesity-related hypertension: epidemiology, pathophysiology, and clinical management. | |
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MedLine Citation:
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PMID: 20706196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The prevalence of obesity, including childhood obesity, is increasing worldwide. Weight gain is associated with increases in arterial pressure, and it has been estimated that 60-70% of hypertension in adults is attributable to adiposity. Centrally located body fat, associated with insulin resistance and dyslipidemia, is a more potent determinant of blood pressure elevation than peripheral body fat. Obesity-related hypertension may be a distinct hypertensive phenotype with distinct genetic determinants. Mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of renin-angiotensin-aldosterone, and altered vascular function. In overweight individuals, weight loss results in a reduction of blood pressure, however, this effect may be attenuated in the long term. An increasing number of community-based programs (including school programs and worksite programs) are being developed for the prevention and treatment of obesity. Assessment and treatment of the obese hypertensive patient should address overall cardiovascular disease (CVD) risk. There are no compelling clinical trial data to indicate that any one class of antihypertensive agents is superior to others, and in general the principles of pharmacotherapy for obese hypertensive patients are not different from nonobese patients. Future research directions might include: (i) development of effective, culturally sensitive strategies for the prevention and treatment of obesity; (ii) clinical trials to identify the most effective drug therapies for reducing CVD in obese, hypertensive patients; (iii) continued search for the genetic determinants of the obese, hypertensive phenotype. |
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Authors:
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Theodore A Kotchen |
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Publication Detail:
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Type: Journal Article Date: 2010-08-12 |
Journal Detail:
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Title: American journal of hypertension Volume: 23 ISSN: 1941-7225 ISO Abbreviation: Am. J. Hypertens. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-19 Completed Date: 2011-01-31 Revised Date: 2011-06-30 |
Medline Journal Info:
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Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 1170-8 Citation Subset: IM |
Affiliation:
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Department of Medicine, Medical College of Wisconsin, Milwaukee, USA. tkotchen@mcw.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adipokines
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physiology Blood Pressure / physiology Humans Hypertension* / epidemiology, physiopathology, therapy Insulin Resistance / physiology Obesity* / epidemiology, physiopathology, therapy Prevalence |
| Chemical | |
Reg. No./Substance:
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0/Adipokines |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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