The treatment of hypertension in obese patients.
Hypertension causes a significant disease burden in all racial and ethnic groups and is directly attributable to excess weight in most cases. The relationship between increasing body mass index and hypertension prevalence has been recognized for decades. Epidemiologic studies clearly demonstrate the correlation between body weight and blood pressure in obese and lean populations. Most patients with hypertension are overweight or obese, and loss of excess weight lowers blood pressure. Although the epidemiologic relationship is clear, the understanding of mechanisms linking hypertension and weight gain is still evolving. Lifestyle modifications and specific pharmacologic agents address many of the known mechanisms; however, blood pressure remains difficult to control in obese hypertensive patients. This review highlights the association of obesity and hypertension, identifies potential mechanisms for this association, and describes nonpharmacologic and pharmacologic strategies that offer potential benefits for the obese patient with hypertension.
Wofford
Marion R
MR
Department of Medicine, Division of General Internal Medicine/Hypertension, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. Mwofford@medicine.umsmed.edu
Smith
Grant
G
Minor
Deborah S
DS
D000367:Age Factors; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D015444:Exercise; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D008019:Life Style; D009043:Motor Activity; D009765:Obesity / Q000150:complications* / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D015430:Weight Gain; D015431:Weight Loss
D019440:Anti-Obesity Agents; D000959:Antihypertensive Agents