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Cited by 265

The DOI matches its Crossref record; 166 of the 166 references it cites were found in a registry or an index.

Obesity, kidney dysfunction, and inflammation: interactions in hypertension

Open access
Hall, John E, Mouton, Alan J, da Silva, Alexandre A, Omoto, Ana C M, Wang, Zhen, Li, Xuan, do Carmo, Jussara M·2021·Cardiovascular Research

Abstract

Obesity contributes 65–75% of the risk for human primary (essential) hypertension (HT) which is a major driver of cardiovascular and kidney diseases. Kidney dysfunction, associated with increased renal sodium reabsorption and compensatory glomerular hyperfiltration, plays a key role in initiating obesity-HT and target organ injury. Mediators of kidney dysfunction and increased blood pressure include (i) elevated renal sympathetic nerve activity (RSNA); (ii) increased antinatriuretic hormones such as angiotensin II and aldosterone; (iii) relative deficiency of natriuretic hormones; (iv) renal compression by fat in and around the kidneys; and (v) activation of innate and adaptive immune cells that invade tissues throughout the body, producing inflammatory cytokines/chemokines that contribute to vascular and target organ injury, and exacerbate HT. These neurohormonal, renal, and inflammatory mechanisms of obesity-HT are interdependent. For example, excess adiposity increases the adipocyte-derived cytokine leptin which increases RSNA by stimulating the central nervous system proopiomelanocortin-melanocortin 4 receptor pathway. Excess visceral, perirenal and renal sinus fat compress the kidneys which, along with increased RSNA, contribute to renin–angiotensin–aldosterone system activation, although obesity may also activate mineralocorticoid receptors independent of aldosterone. Prolonged obesity, HT, metabolic abnormalities, and inflammation cause progressive renal injury, making HT more resistant to therapy and often requiring multiple antihypertensive drugs and concurrent treatment of dyslipidaemia, insulin resistance, diabetes, and inflammation. More effective anti-obesity drugs are needed to prevent the cascade of cardiorenal, metabolic, and immune disorders that threaten to overwhelm health care systems as obesity prevalence continues to increase.

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Metadata

Authors
Hall, J. E., Mouton, A. J., da Silva, A. A., Omoto, A. C. M., Wang, Z., Li, X., & do Carmo, J. M.
Venue
Cardiovascular Research
Published
2020-12-01
Volume
117
Issue
8
Pages
1859-1876
ISSN
  • 0008-6363 (ISSN-L)
  • 1755-3245
OpenAlex
W3107928135
Cited by
265
References
166
FWCI
11.73
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Obesity, kidney dysfunction, and inflammation: interactions in hypertension. https://app.cochat.ai/papers/10.1093/cvr/cvaa336
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Hall, J. E., Mouton, A. J., da Silva, A. A., Omoto, A. C. M., Wang, Z., Li, X., & do Carmo, J. M. (2021). Obesity, kidney dysfunction, and inflammation: interactions in hypertension. Cardiovascular Research. https://doi.org/10.1093/cvr/cvaa336

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