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The pathophysiology of hypertension in patients with obesity
Open accessAbstract
The combination of obesity and hypertension is associated with high morbidity and mortality because it leads to cardiovascular and kidney disease. Potential mechanisms linking obesity to hypertension include dietary factors, metabolic, endothelial and vascular dysfunction, neuroendocrine imbalances, sodium retention, glomerular hyperfiltration, proteinuria, and maladaptive immune and inflammatory responses. Visceral adipose tissue also becomes resistant to insulin and leptin and is the site of altered secretion of molecules and hormones such as adiponectin, leptin, resistin, TNF and IL-6, which exacerbate obesity-associated cardiovascular disease. Accumulating evidence also suggests that the gut microbiome is important for modulating these mechanisms. Uric acid and altered incretin or dipeptidyl peptidase 4 activity further contribute to the development of hypertension in obesity. The pathophysiology of obesity-related hypertension is especially relevant to premenopausal women with obesity and type 2 diabetes mellitus who are at high risk of developing arterial stiffness and endothelial dysfunction. In this Review we discuss the relationship between obesity and hypertension with special emphasis on potential mechanisms and therapeutic targeting that might be used in a clinical setting.
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“2) activation of the renin-angiotensin-aldosterone system (RAAS)”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [37]
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Metadata
- Authors
- DeMarco, V. G., Aroor, A. R., & Sowers, J. R.
- Affiliations
- University of Missouri (US)
- Corresponding author
- Sowers, James R.
- Venue
- Nature Reviews Endocrinology
- Published
- 2014-04-15
- Volume
- 10
- Issue
- 6
- Pages
- 364-376
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- PMC
- PMC4308954
- OpenAlex
- W2012416246
- Cited by
- 545
- References
- 238
- Citations by year
- 2026: 30 · 2025: 41 · 2024: 38 · 2023: 70 · 2022: 48 · 2021: 51 · 2020: 56 · 2019: 53 · 2018: 40 · 2017: 41 · 2016: 40 · 2015: 26 · 2014: 11
- FWCI
- 6.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- CYTED Ciencia y Tecnología para el Desarrollo
- National Institutes of Health (5r01hl107910-03)
- National Heart, Lung, and Blood Institute (R01 HL73101‑01A1, R01 HL 107910-01, R01-HL-107910, R01HL073101)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- obesity, obesity-related hypertension, pathophysiology, visceral adipose tissue, endothelial dysfunction, sodium retention, glomerular hyperfiltration, proteinuria, insulin resistance, leptin resistance, adiponectin, resistin, TNF-α, interleukin-6, gut microbiota, uric acid, incretins, dipeptidyl peptidase IV, arterial stiffness, premenopausal women, type 2 diabetes, cardiovascular disease, kidney disease
- MeSH terms
- Cardiotonic Agents, Diet, Humans, Hypertension, Life Style, Obesity
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