Antihypertensive therapy in obesity
https://doi.org/10.21518/2079-701X-2014-17-42-49
Abstract
Obesity today is one of the most relevant interdisciplinary problems in healthcare and one of the key reasons for blood pressure increase. Thus, according to the Framingham Heart Study,78% of hypertension in men and 65% in women can be directly attributed to obesity [10]. Fat cells play an important role in the development of hypertension, i.e. they generate a variety of biologically active substances some of which have pressor and proinflammatory effects. Leptin is one of key substances which contributes to the increase of AP through the activation of the sympathetic nervous system and direct effect on kidneys (increased sodium reabsorption). Furthermore, obesity itself adversely affects the structure of renal tissue and increases the risk of progression of renal failure and hypertension. In addition, fatty tissue has its own renin-angiotensin system and may actively produce angiotensin.
About the Authors
S. V. Nedogoda
Volgograd State Medical University
Russian Federation
Russian Federation
A. S. Salasyuk
Volgograd State Medical University
Russian Federation
Russian Federation
I. N. Barykina
Volgograd State Medical University
Russian Federation
Russian Federation
V. V. Tsoma
Volgograd State Medical University
Russian Federation
Russian Federation
E. V. Chumachek
Volgograd State Medical University
Russian Federation
Russian Federation
V. Y. Khripaeva
Volgograd State Medical University
Russian Federation
Russian Federation
References
1. Недогода С.В. Ожирение и артериальная гипертензия: теория и практика выбора оптимального гипотензивного препарата. М.: Медиком, 2012. С. 1-80.
2. Bergman RN, Van Otters GW, Mittelman SD et al. Central role of adipocyte in the metabolic syndrome. J Invest Med, 2001, 49: 119-126.
3. Chu NF, Spiegelman D, Hotamisligil GS et al. Plasma insulin, leptin, and soluble TNF receptors levels in relation to obesity-related atherogenic and thrombogenic cardiovascular disease factors among men. Atherosclerosis, 2001, 157: 495-503.
4. Drenick EJ, Bale GS, Seltzer F, Johnson DG. Excessive mortality and cause of death in morbidly obese men.JAMA, 1980, 243: 443-445.
5. Esler M The sympathetic system and hypertension. Am JHypertens, 2000, 13: 99S-105S.
6. Gorzelniak K, Engeli S, Janke J et al. Hormonal regulation of the human adipose-tissue renin-angiotensin system: relationship to obesity and hypertension. J Hypertens, 2002, 20: 1115-1120.
7. Gupta AK, Clark RV, Kirchner KA. Effects of insulin on renal sodium excretion. Hypertension,1992, 19 (suppl. 1): I78-I82.
8. Hall JE. Mechanisms of abnormal renal sodium handling in obesity hypertension. Am J Hypertens, 1997, 10: 49S-55S.
9. Kuo J, Jones OB, Hall JE. Inhibition of NO synthesis enhances chronic cardiovascular and renal actions of leptin. Hypertension, 2001, 37: 670-676.
10. Licata G, Scaglione, Capuana G, Parrinello G, Divincenzo D, Mazzola G. Hypertension in obese subjects: distinct hypertensive subgroup. J Hum Hypertens, 1990, 4: 37-41.
11. Laasko M, Edelman SV, Brechtel G, Baron AD. Decreased effect of insulin to stimulate skeletal muscle blood flow in obese men. J Clin Invest, 1990, 85: 1844-1852.
12. Mansuo K, Mikami H, Ogihara T, Tuck ML 2000 Weight gain-induced blood pressure elevation. Hypertension, 35: 1135-1140.
13. Messerli FH, Sundgard-Riiske K, Reisin E, Frohlich ED, Dunn FG. Dimorphic cardiac adaptation to obesity and arterial hypertension. Ann Intern Med, 1998, 99: 757-761.
14. Nedogoda S et al. Randomized Trial of Perindopril, Enalapril, Losartan And Telmisartan in Overweight or Obese Patients With Hypertension. Clin Drug Investig, 2013, 33: 553-561.
15. Rumantir MS, Vaz M, Jennings GL, Collier G, Kaye DM, Seals DR, Wiesner GH, Brunner-LaRocca HP, Esler MD. Neural mechanisms in human obesity-related hypertension. J Hypertens, 1999, 17: 1125-1133.
16. Sharma AM, Pischon T, Engeli S et al. Choice of drug treatment for obesity-related hypertension: where is the evidence? J Hypertens, 2001, 19: 667-674.
17. Shek EW, Kim PK, Hall JE. Adrenergic blockade prevents leptin-induced hypertension. FASEB J, 1999, 13: A456.
18. Zhang R, Reisin E Obesity-hypertension: the effects on cardiovascular and renal systems. Am J Hypertens, 2000, 13: 1308-1314.
Review
For citations:
Nedogoda SV, Salasyuk AS, Barykina IN, Tsoma VV, Chumachek EV, Khripaeva VY. Antihypertensive therapy in obesity. Meditsinskiy sovet = Medical Council. 2014;(17):42-49. (In Russ.) https://doi.org/10.21518/2079-701X-2014-17-42-49
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