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Evaluation and Treatment of Hypertension

  • Quang T. Nguyen
  • Raymond A. Plodkowski
Chapter

Abstract

The objective of this chapter is to discuss comprehensive care for the patient with obesity and provide a framework for treating these patients.

Each patient with obesity must be evaluated individually. The blood pressure goal in obese patients with hypertension is similar to the general population, with lifestyle changes the cornerstone of obesity treatment. Obese, hypertensive patients should limit their sodium intake to 2.3–3 g/day, potassium intake to >3.5 g/day, alcohol restriction <1 oz./day, and exercise >30 min/day. The other primary focus is weight loss, as there is a dose-response relationship between the amount of weight loss achieved and the lowering of blood pressure. Pharmacologic therapy involves the same classes of medication as the nonobese patients. However, preventing further weight gain should be a goal.

Treating hypertension in the obese patients requires a multifactorial approach, and treating obesity should be the primary focus of the overall treatment plan. Lifestyle management must focus on decreasing sodium, alcohol, and caloric intake, increasing potassium and physical activities should be stressed. Finally, weight loss medications may be necessary to achieve progressive or sustained weight loss. If weight loss is not possible, at least weight maintenance should be the goal.

Keywords

Obesity Hypertension Medical evaluation Lifestyle changes Pharmacotherapy 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Quang T. Nguyen
    • 1
  • Raymond A. Plodkowski
    • 2
  1. 1.Las Vegas Endocrinology, Clinical Education, AZCOM, TUNCOMHendersonUSA
  2. 2.University of California San Diego, Division of Endocrinology and Metabolism, Scripps ClinicSan DiegoUSA

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