Cited by 63Regulation of Appetite and ObesityAdipokines, Inflammation, and Metabolic DiseasesBlood Pressure and Hypertension Studies

Role of leptin and central nervous system melanocortins in obesity hypertension

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da Silva, Alexandre A., Carmo, Jussara M. do, Hall, John E.·2013·Current Opinion in Nephrology and Hypertension

Abstract

PURPOSE OF REVIEW: Obesity is a major worldwide health problem. Excess weight gain is the most significant preventable cause of increased blood pressure (BP) in patients with essential hypertension and increases the risk for cardiovascular and renal diseases. Our goal is to review the mechanisms that link obesity with hypertension, with special emphasis on the role of leptin and the brain melanocortin system in driving sympathetic activation in obesity. RECENT FINDINGS: Despite increased interest in obesity as a major risk for developing hypertension, the precise mechanisms linking excess weight gain with increases in BP are still elusive. Current evidence suggests that increased sympathetic nervous system (SNS) activity contributes to impaired renal-pressure natriuresis and sodium retention in obesity. Recent findings indicate that the adipocyte-derived hormone, leptin, activates brain centers that regulate SNS activity through a melanocortin-system-dependent pathway. The interaction of leptin and the brain melanocortin system represents an important area of research to further our understanding of the mechanisms leading to sympathetic activation in obesity. SUMMARY: Sympathetic overactivity is an important link between excess weight gain and increased BP. Hormones and cytokines secreted by the adipose tissue that interact with neural pathways (e.g. melanocortin system) appear to play a key role in contributing to sympathetic activation in obesity and represent potential new targets for therapies.

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  • Leptin and the CNS POMC pathway appear to be important in obesity-induced SNS activation and hypertension.

    “Although the role of many of these factors is still uncertain, leptin and the CNS POMC pathway appear to be important in obesity-induced SNS activation and hypertension17,80–82.”
  • Mice with whole-body MC4R deficiency are hyperphagic and obese, and have many characteristics of the metabolic syndrome including hyperglycemia, hyperinsulinemia, visceral adiposity and dyslipidemia despite markedly elevated blood leptin levels.

    “Mice with whole-body MC4R deficiency are hyperphagic and obese, and have many characteristics of the metabolic syndrome including hyperglycemia, hyperinsulinemia, visceral adiposity and dyslipidemia despite markedly elevated blood leptin levels [27, 28, 52]; moreover, these mice are completely unresponsive to the effects of leptin to reduce appetite and to raise BP [27].”

    From Role of the brain melanocortins in blood pressure regulation (2017) · cites this paper as [52]

  • Leptin requires functional MC4R for most of its chronic cardiovascular and metabolic effects.

    “Leptin requires functional MC4R for most of its chronic cardiovascular and metabolic effects.”

    From Role of the brain melanocortins in blood pressure regulation (2017) · cites this paper as [52]

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Authors
da Silva, A. A., Carmo, J. M. D., & Hall, J. E.
Affiliations
University of Mississippi Medical Center (US)
Venue
Current Opinion in Nephrology and Hypertension
Published
2013-03
Volume
22
Issue
2
Pages
135-140
ISSN
1062-4821 (ISSN-L)
OpenAlex
W1992968247
Cited by
63
References
36
Citations by year
2026: 2 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 2 · 2018: 7 · 2017: 10 · 2016: 4 · 2015: 11 · 2014: 5 · 2013: 6
FWCI
1.05
Type
journal article
Language
en
Open access
Locations
  • Current Opinion in Nephrology & Hypertension (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (P01-HL-51971, P01HL051971)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
leptin, melanocortin system, obesity, essential hypertension, sympathetic activation, pressure natriuresis, sodium retention, adipokines, central nervous system regulation of blood pressure
MeSH terms
Animals, Blood Pressure, Central Nervous System, Humans, Hypertension, Obesity, Sympathetic Nervous System, Signal Transduction, Weight Gain, Adipocytes, Leptin, Receptor, Melanocortin, Type 4, Melanocortins

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