Obesity and Hypertension

Year 2019, , 6 - 14, 29.10.2019

Canan Ersoy , Alparslan Ersoy

https://doi.org/10.46310/tjim.634597

Abstract

Obesity is an important public
health problem with increasing frequency, leading to different comorbidities
including hypertension and can cause mortality. Possible mechanisms that
increase blood pressure in overweight and obese people are renal damage,
activation of the renin-angiotensin-aldosterone system, insulin resistance,
hyperinsulinemia, sleep apnea syndrome, leptin-melanocortin pathway and genetic
predisposition. Most of these mechanisms stimulate the sympathetic nervous
system. Medical nutrition therapy, lifestyle interventions, medical and/or
surgical antiobesity treatment modalities contribute to the control of blood
pressure via weight loss. Besides antihypertensive medications should be chosen
carefully in overweight and obese patients and drug groups preventing weight
loss should not be preferred if possible. 

Keywords

obesity, overweight, hypertension, kidney

References

• Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/ PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. doi: 10.1016/j.jacc.2017.11.006.
• Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019 Feb 27. doi: 10.1038/s41574-019-0176-8. [Epub ahead of print]
• Csige I, Ujvárosy D, Szabó Z, Lőrincz I, Paragh G, Harangi M, Somodi S. The Impact of Obesity on the Cardiovascular System. J Diabetes Res. 2018 Nov 4;2018:3407306. doi: 10.1155/2018/3407306.
• Saydah S, Bullard KM, Cheng Y, Ali MK, Gregg EW, Geiss L, Imperatore G. Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999-2010. Obesity (Silver Spring). 2014 Aug;22(8):1888-95. doi: 10.1002/oby.20761. Epub 2014 Apr 15.
• Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med. 1999;341(6):427-34.
• Huang Z, Willett WC, Manson JE, Rosner B, Stampfer MJ, Speizer FE, Colditz GA. Body weight, weight change, and risk for hypertension in women. Ann Intern Med. 1998 Jan 15;128(2):81-8.
• Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, Rimm E, Colditz GA. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001 Jul 9;161(13):1581-6.
• Türkiye Endokrinoloji ve Metabolizma Derneği. Obezite Tanı ve Tedavi Kılavuzu 2019. 8. baskı. Ankara: Miki Matbaacılık; 2019: 1-113.
• Schmieder RE, Messerli FH. Does obesity influence early target organ damage in hypertensive patients? Circulation. 1993;87(5):1482-8.
• Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015;116(6):991-1006. doi: 10.1161/CIRCRESAHA.116.305697.
• Sarzani R, Salvi F, Dessì-Fulgheri P, Rappelli A. Renin-angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans. J Hypertens. 2008 May;26(5):831-43. doi: 10.1097/HJH.0b013e3282f624a0.
• Seravalle G, Grassi G. Obesity and hypertension. Pharmacol Res. 2017 Aug;122:1-7. doi: 10.1016/j.phrs.2017.05.013. Epub 2017 May 19.
• Rahmouni K. Obesity, sympathetic overdrive, and hypertension: the leptin connection. Hypertension. 2010;55(4):844-5. doi:10.1161/HYPERTENSIONAHA.109.148932.
• do Carmo JM, da Silva AA, Wang Z, Fang T, Aberdein N, Perez de Lara CE, Hall JE. Role of the brain melanocortins in blood pressure regulation. Biochim Biophys Acta Mol Basis Dis. 2017;1863(10 Pt A):2508-14. doi: 10.1016/j.bbadis.2017.03.003.
• Tsuboi N, Okabayashi Y, Shimizu A, Yokoo T. The Renal Pathology of Obesity. Kidney Int Rep. 2017 Jan 23;2(2):251-60. doi: 10.1016/j.ekir.2017.01.007.
• Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008 Feb 15;5(2):136-43. doi: 10.1513/pats.200709-155MG.
• Schwartz AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL. Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc. 2008 Feb 15;5(2):185-92. doi: 10.1513/pats.200708-137MG.
• Darouich S, Goucha R, Jaafoura MH, Zekri S, Ben Maiz H, Kheder A. Clinicopathological characteristics of obesity-associated focal segmental glomerulosclerosis. Ultrastruct Pathol. 2011;35(4):176-82. doi: 10.3109/01913123.2011.584657.
• Kambham N, Markowitz GS, Valeri AM, Lin J, D'Agati VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001 Apr;59(4):1498-509.
• Tsuboi N, Utsunomiya Y, Kanzaki G, Koike K, Ikegami M, Kawamura T, Hosoya T. Low glomerular density with glomerulomegaly in obesity-related glomerulopathy. Clin J Am Soc Nephrol. 2012 May;7(5):735-41. doi: 10.2215/CJN.07270711.
• Praga M, Hernández E, Morales E, Campos AP, Valero MA, Martínez MA, León M. Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis. Nephrol Dial Transplant. 2001;16(9):1790-8.
• Salvatore SP, Chevalier JM, Kuo SF, Audia PF, Seshan SV. Kidney disease in patients with obesity: It is not always obesity-related glomerulopathy alone. Obes Res Clin Pract. 2017 Sep - Oct;11(5):597-606. doi: 10.1016/j.orcp.2017.04.003.
• Adelman RD, Restaino IG, Alon US, Blowey DL. Proteinuria and focal segmental glomerulosclerosis in severely obese adolescents. J Pediatr. 2001;138(4):481-5.
• Praga M, Hernández E, Andrés A, León M, Ruilope LM, Rodicio JL. Effects of body-weight loss and captopril treatment on proteinuria associated with obesity. Nephron. 1995;70(1):35-41.
• Fowler SM, Kon V, Ma L, Richards WO, Fogo AB, Hunley TE. Obesity-related focal and segmental glomerulosclerosis: normalization of proteinuria in an adolescent after bariatric surgery. Pediatr Nephrol. 2009;24(4):851-5. doi: 10.1007/s00467-008-1024-6.
• Kato S, Nazneen A, Nakashima Y, Razzaque MS, Nishino T, Furusu A, Yorioka N, Taguchi T. Pathological influence of obesity on renal structural changes in chronic kidney disease. Clin Exp Nephrol. 2009 Aug;13(4):332-40. doi: 10.1007/s10157-009-0169-3.
• Goumenos DS, Kawar B, El Nahas M, Conti S, Wagner B, Spyropoulos C, Vlachojannis JG, Benigni A, Kalfarentzos F. Early histological changes in the kidney of people with morbid obesity. Nephrol Dial Transplant. 2009 Dec;24(12):3732-8. doi: 10.1093/ndt/gfp329.
• de Vries AP, Ruggenenti P, Ruan XZ, Praga M, Cruzado JM, Bajema IM, D'Agati VD, Lamb HJ, Pongrac Barlovic D, Hojs R, Abbate M, Rodriquez R, Mogensen CE, Porrini E; ERA-EDTA Working Group Diabesity. Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol. 2014 May;2(5):417-26. doi: 10.1016/S2213-8587(14)70065-8.
• Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018 Jun;71(6):e13-e115. doi: 10.1161/HYP.0000000000000065.
• Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003 Nov;42(5):878-84.
• Semlitsch T, Jeitler K, Berghold A, Horvath K, Posch N, Poggenburg S, Siebenhofer A. Long-term effects of weight-reducing diets in people with hypertension. Cochrane Database Syst Rev. 2016 Mar 2;3:CD008274. doi: 10.1002/14651858.CD008274.pub3.
• Cohen JB. Hypertension in Obesity and the Impact of Weight Loss. Curr Cardiol Rep. 2017 Aug 24;19(10):98. doi: 10.1007/s11886-017-0912-4.
• Jin J. JAMA PATIENT PAGE. Specific Medications for Weight Loss. JAMA. 2015 Aug 18;314(7):742. doi: 10.1001/jama.2015.5836.
• Sharma AM, Golay A. Effect of orlistat-induced weight loss on blood pressure and heart rate in obese patients with hypertension. J Hypertens. 2002;20(9):1873-8.
• Siebenhofer A, Jeitler K, Horvath K, Berghold A, Posch N, Meschik J, Semlitsch T. Long-term effects of weight-reducing drugs in people with hypertension. Cochrane Database Syst Rev. 2016 Mar 2;3:CD007654. doi: 10.1002/14651858.CD007654.pub4.
• Wadden TA, Walsh OA, Berkowitz RI, Chao AM, Alamuddin N, Gruber K, Leonard S, Mugler K, Bakizada Z, Tronieri JS. Intensive Behavioral Therapy for Obesity Combined with Liraglutide 3.0 mg: A Randomized Controlled Trial. Obesity (Silver Spring). 2019;27(1):75-86. doi: 10.1002/oby.22359.
• Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, Hertel JK, Hjelmesæth J. Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities. JAMA. 2018;319(3):291-301. doi: 10.1001/jama.2017.21055.
• Sjöström CD, Peltonen M, Wedel H, Sjöström L. Differentiated long-term effects of intentional weight loss on diabetes and hypertension. Hypertension. 2000 Jul;36(1):20-5.
• Hall JE, Hall ME. Cardiometabolic Surgery for Treatment of Hypertension? Hypertension. 2019 Mar;73(3):543-6. doi: 10.1161/HYPERTENSIONAHA.118.12369.
• Jebb SA, Ahern AL, Olson AD, Aston LM, Holzapfel C, Stoll J, Amann-Gassner U, Simpson AE, Fuller NR, Pearson S, Lau NS, Mander AP, Hauner H, Caterson ID. Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial. Lancet. 2011 Oct 22;378(9801):1485-92. doi: 10.1016/S0140-6736(11)61344-5.
• Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, Nadolsky K, Pessah-Pollack R, Plodkowski R; Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity. Endocr Pract. 2016 Jul;22 Suppl 3:1-203. doi: 10.4158/EP161365.GL.
• Jordan J, Yumuk V, Schlaich M, Nilsson PM, Zahorska-Markiewicz B, Grassi G, Schmieder RE, Engeli S, Finer N. Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and difficult to treat arterial hypertension. J Hypertens. 2012 Jun;30(6):1047-55. doi: 10.1097/HJH.0b013e3283537347.
• Ogihara T, Nakao K, Fukui T, Fukiyama K, Ueshima K, Oba K, Sato T, Saruta T; Candesartan Antihypertensive Survival Evaluation in Japan Trial Group. Effects of candesartan compared with amlodipine in hypertensive patients with high cardiovascular risks: candesartan antihypertensive survival evaluation in Japan trial. Hypertension. 2008 Feb;51(2):393-8. doi: 10.1161/HYPERTENSIONAHA.107.098475.
• Pischon T, Sharma AM. Use of beta-blockers in obesity hypertension: potential role of weight gain. Obes Rev. 2001 Nov;2(4):275-80.
• Lee P, Kengne AP, Greenfield JR, Day RO, Chalmers J, Ho KK. Metabolic sequelae of β-blocker therapy: weighing in on the obesity epidemic? Int J Obes (Lond). 2011 Nov;35(11):1395-403. doi: 10.1038/ijo.2010.284.
• Dronavalli S, Bakris GL. Mechanistic insights into diuretic-induced insulin resistance. Hypertension. 2008;52(6):1009-11. doi: 10.1161/HYPERTENSIONAHA.108.120923.
• Sowers JR, Raij L, Jialal I, Egan BM, Ofili EO, Samuel R, Zappe DH, Purkayastha D, Deedwania PC. Angiotensin receptor blocker/diuretic combination preserves insulin responses in obese hypertensives. J Hypertens. 2010 Aug;28(8):1761-9. doi: 10.1097/HJH.0b013e32833af380.
• Weber MA, Bakris GL, Jamerson K, Weir M, Kjeldsen SE, Devereux RB, Velazquez EJ, Dahlöf B, Kelly RY, Hua TA, Hester A, Pitt B; ACCOMPLISH Investigators. Cardiovascular events during differing hypertension therapies in patients with diabetes. J Am Coll Cardiol. 2010 Jun 29;56(1):77-85. doi: 10.1016/j.jacc.2010.02.046.
• Weber MA, Jamerson K, Bakris GL, Weir MR, Zappe D, Zhang Y, Dahlof B, Velazquez EJ, Pitt B. Effects of body size and hypertension treatments on cardiovascular event rates: subanalysis of the ACCOMPLISH randomised controlled trial. Lancet. 2013 Feb 16;381(9866):537-45. doi: 10.1016/S0140-6736(12)61343-9.
• Barzilay JI, Howard AG, Evans GW, Fleg JL, Cohen RM, Booth GL, Kimel AR, Pedley CF, Cushman WC. Intensive blood pressure treatment does not improve cardiovascular outcomes in centrally obese hypertensive individuals with diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial. Diabetes Care. 2012 Jul;35(7):1401-5. doi: 10.2337/dc11-1827.
• Shimamoto K, Ando K, Fujita T, Hasebe N, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ishimitsu T, Ito M, Ito S, Itoh H, Iwao H, Kai H, Kario K, Kashihara N, Kawano Y, Kim-Mitsuyama S, Kimura G, Kohara K, Komuro I, Kumagai H, Matsuura H, Miura K, Morishita R, Naruse M, Node K, Ohya Y, Rakugi H, Saito I, Saitoh S, Shimada K, Shimosawa T, Suzuki H, Tamura K, Tanahashi N, Tsuchihashi T, Uchiyama M, Ueda S, Umemura S; Japanese Society of Hypertension Committee for Guidelines for the Management of Hypertension. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014). Hypertens Res. 2014 Apr;37(4):253-390. doi: 10.1038/hr.2014.20.
• Le Jemtel TH, Richardson W, Samson R, Jaiswal A, Oparil S. Pathophysiology and Potential Non-Pharmacologic Treatments of Obesity or Kidney Disease Associated Refractory Hypertension. Curr Hypertens Rep. 2017 Feb;19(2):18. doi: 10.1007/s11906-017-0713-6.
• Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. doi: 10.1093/eurheartj/ehy339.
• Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM, Binno S; ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016 Aug 1;37(29):2315-81. doi: 10.1093/eurheartj/ehw106.
• Prospective Studies Collaboration, Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009 Mar 28;373(9669):1083-96. doi: 10.1016/S0140-6736(09)60318-4.
• Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013 Jan 2;309(1):71-82. doi: 10.1001/jama.2012.113905.
• Global BMI Mortality Collaboration, Di Angelantonio E, Bhupathiraju ShN, Wormser D, Gao P, Kaptoge S, Berrington de Gonzalez A, Cairns BJ, Huxley R, Jackson ChL, Joshy G, Lewington S, Manson JE, Murphy N, Patel AV, Samet JM, Woodward M, Zheng W, Zhou M, Bansal N, Barricarte A, Carter B, Cerhan JR, Smith GD, Fang X, Franco OH, Green J, Halsey J, Hildebrand JS, Jung KJ, Korda RJ, McLerran DF, Moore SC, O'Keeffe LM, Paige E, Ramond A, Reeves GK, Rolland B, Sacerdote C, Sattar N, Sofianopoulou E, Stevens J, Thun M, Ueshima H, Yang L, Yun YD, Willeit P, Banks E, Beral V, Chen Zh, Gapstur SM, Gunter MJ, Hartge P, Jee SH, Lam TH, Peto R, Potter JD, Willett WC, Thompson SG, Danesh J, Hu FB. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016 Aug 20;388(10046):776-86. doi: 10.1016/S0140-6736(16)30175-1.
• Cohen JB, Gadde KM. Weight Loss Medications in the Treatment of Obesity and Hypertension. Curr Hypertens Rep. 2019 Feb 12;21(2):16. doi: 10.1007/s11906-019-0915-1.
• Rosa-Gonçalves P, Majerowicz D. Pharmacotherapy of Obesity: Limits and Perspectives. Am J Cardiovasc Drugs. 2019 Aug;19(4):349-64. doi: 10.1007/s40256-019-00328-6.