[Treatment of hypertension in obese patients].
Prevalence of obesity and hypertension has increased these last decades. Around 60 to 70% of the incidence of hypertension is related to obesity. The relationship between obesity and hypertension is now well established. The sympathetic nervous system and the renin-angiotensin-aldosterone (RAA) system are activated in obese patients, mostly by insulin, and predispose the kidney to reabsorb sodium and water. In obese patients with hypertension, it is recommended to target a blood pressure < 140/90 mmHg. Lifestyle changes (weight loss, physical activity, low-salt diets) are useful to decrease blood pressure but are difficult to maintain in the long-term. When drugs are necessary, drugs that are metabolically neutral should be used, and often need to be combined to other drug classes in order to achieve blood pressure target.
Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne. sophie.comte@chuv.ch
Sophie
S
Comte-Perret
Vittorio
V
Giusti
Grégoire
G
Wuerzner
D001794:Blood Pressure / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015994:Incidence; D007328:Insulin / Q000378:metabolism; D008019:Life Style; D009765:Obesity / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D015995:Prevalence; D012084:Renin-Angiotensin System / Q000502:physiology; D013564:Sympathetic Nervous System / Q000378:metabolism
D007328:Insulin