ABSTRACT
Hypertension occurs more commonly in obese than in lean persons at virtually every
age. A variety of endocrine, genetic, and metabolic mechanisms have been linked to
the development of obesity hypertension. These include insulin resistance and hyperinsulinemia,
increased serum aldosterone levels, salt sensitivity and expanded plasma volume in
the presence of increased peripheral vascular resistance, a genetic predisposition,
and possibly increased leptin levels. Pressure and volume overload are present in
obese hypertensives. This leads to a mixed eccentric-concentric form of left ventricular
hypertrophy and increases the predisposition to congestive heart failure. Weight loss,
even in modest decrements, is effective in reducing obesity-hypertension, possibly
by ameliorating several of the proposed pathophysiologic mechanisms. There are currently
no specific recommendations concerning pharmacotherapy of obesity-hypertension because
each drug group has pros and cons.
KEY INDEXING TERMS
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© 2001 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
