The Renin Angiotensin Aldosterone System in Obesity and Hypertension
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In the United States, more than 50 million people have blood pressure at or above 120/80 mm Hg. All components of cardiorenal metabolic syndrome (CRS) are linked to metabolic abnormalities and obesity. A major driver for CRS is obesity. Current estimates show that many of those with hypertension and CRS show some degree of systemic and cardiovascular insulin resistance. Several pathophysiologic factors participate in the link between hypertension and CRS. This article updates recent literature with a focus on the function of insulin resistance, obesity, and renin angiotensin aldosterone system-mediated oxidative stress on endothelial dysfunction and the pathogenesis of hypertension.
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Mild elevations in angiotensin II levels in obesity are driven largely by increased renal renin secretion due to sympathetic nervous system activation, kidney compression, and other factors such as adipokines.
“Current evidence suggests that mild elevations in AngII levels in obesity are driven largely by increased renal renin secretion due to SNS activation, kidney compression and perhaps other factors such as adipokines51,60.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [60]
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- Authors
- Cabandugama, P. K., Gardner, M. J., & Sowers, J. R.
- Affiliations
- University of Missouri (US)
- Harry S. Truman Memorial Veterans' Hospital (US)
- Corresponding author
- Sowers, James R.
- ORCID
- Sowers, James R.
- Venue
- Medical Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 101
- Issue
- 1
- Pages
- 129-137
- ISSN
- 0025-7125 (ISSN-L)
- PMC
- PMC5125542
- OpenAlex
- W2559632920
- Cited by
- 168
- References
- 45
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 20 · 2023: 10 · 2022: 20 · 2021: 31 · 2020: 26 · 2019: 16 · 2018: 14 · 2017: 8 · 2016: 1
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Medical Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01 BX001981)
- National Institutes of Health (5r01hl107910-03)
- National Heart, Lung, and Blood Institute (R01-HL-107910, R01HL073101)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Eicosanoids and Hypertension Pharmacology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- renin-angiotensin-aldosterone system, obesity, hypertension, cardiorenal metabolic syndrome, insulin resistance, oxidative stress, endothelial dysfunction, hypertension pathogenesis
- MeSH terms
- Renin Inhibitors, Mineralocorticoid Receptor Antagonists, Humans, Hypertension, Obesity, Renin-Angiotensin System, Sympathetic Nervous System, Cardio-Renal Syndrome
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