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Obesity and Metabolic Syndrome Hypertension

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Disorders of Blood Pressure Regulation

Abstract

Obesity is a growing problem worldwide, and excess visceral adiposity is a major risk factor for many metabolic, kidney, and cardiovascular disorders including primary (essential) hypertension. The mechanisms by which obesity leads to hypertension and kidney dysfunction are not completely understood, but physical compression of the kidneys and activation of the renin-angiotensin-aldosterone and sympathetic nervous systems appear to initially increase renal sodium reabsorption, impair renal-pressure natriuresis, and ultimately raise blood pressure. Other factors such as lipotoxicity and endothelial and vascular dysfunction may accompany and/or exacerbate increased blood pressure as obesity is sustained. Concomitant vascular and metabolic derangements such as hyperglycemia and inflammation interact with increased blood pressure to cause kidney injury which exacerbates the hypertension, making it more difficult to control while causing further renal injury. Maintenance of a healthy weight is important for primary prevention of hypertension and kidney disease. Weight loss, if it can be achieved, appears to be effective in treating many patients with chronic hypertension and kidney disease. However, long-term weight management is challenging for many people, and more effective therapeutic options are needed.

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Hall, M.E., Wang, Z., do Carmo, J., Kamimura, D., Hall, J.E. (2018). Obesity and Metabolic Syndrome Hypertension. In: Berbari, A., Mancia, G. (eds) Disorders of Blood Pressure Regulation. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-59918-2_42

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  • DOI: https://doi.org/10.1007/978-3-319-59918-2_42

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