Pathophysiology and Potential Non-Pharmacologic Treatments of Obesity or Kidney Disease Associated Refractory Hypertension

  • Thierry H Le Jemtel
  • William Richardson
  • Rohan Samson
  • Abhishek Jaiswal
  • Suzanne Oparil
Resistant Hypertension (E Pimenta, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Resistant Hypertension


Purpose of Review

The review assesses the role of non-pharmacologic therapy for obesity and chronic kidney disease (CKD) associated refractory hypertension (rf HTN).

Recent Findings

Hypertensive patients with markedly heightened sympathetic nervous system (SNS) activity are prone to develop refractory hypertension (rfHTN). Patients with obesity and chronic kidney disease (CKD)-associated HTN have particularly heightened SNS activity and are at high risk of rfHTN. The role of bariatric surgery is increasingly recognized in treatment of obesity.


Current evidence advocates for a greater role of bariatric surgery in the management of obesity-associated HTN. In contrast, renal denervation does not appear have a role in the management of obesity or CKD-associated HTN. The role of baroreflex activation as adjunctive anti-hypertensive therapy remains to be defined.


Obesity Hypertension Bariatric surgery Chronic kidney disease Renal denervation 


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Thierry H Le Jemtel
    • 1
    • 2
  • William Richardson
    • 3
  • Rohan Samson
    • 1
  • Abhishek Jaiswal
    • 1
  • Suzanne Oparil
    • 4
  1. 1.Division of CardiologyTulane University Medical CenterLouisianaUSA
  2. 2.Division of CardiologyTulane University School of MedicineNew OrleansUSA
  3. 3.Department of SurgeryOchsner Health SystemLouisianaUSA
  4. 4.Division of Cardiovascular DiseaseUniversity of AlabamaBirminghamUSA

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