[Fat control--an effective antihypertensive strategy. Special recommendations for therapy of the overweight patient].
Some 44% of all patients with elevated blood pressure are overweight. In obesity-related hypertension, sympathicotonia is regularly found, together with elevated intracellular calcium, sodium retention, increased cardiac output (per minute) and a sensitivity to salt. The role played by hyperinsulinemia has apparently been overstated. A primary rise in the minimal vascular resistance suffices to reduce the perfusion of the skeletal musculature and, solely on this basis, to induce insulin resistance. For the treatment of obesity-related hypertension, non-medicinal approaches to weight reduction predominate. Reducing the daily salt intake to 5 g can also bring about a measurable reduction in blood pressure. For the treatment with antihypertensive drugs, beta blockers and diuretics are the initial choice; in the case of pronounced metabolic syndrome, ACE-inhibitors and alpha-1 receptors.
Bönner
G
G
Medizinischen Kliniken, Klinik Lazariterhof, Bad Krozingen.
D015992:Body Mass Index; D018752:Diet, Fat-Restricted; D004039:Diet, Sodium-Restricted; D015444:Exercise; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000209:etiology*; D007333:Insulin Resistance; D009765:Obesity / Q000150:complications* / Q000178:diet therapy; D014655:Vascular Resistance