Treatment of hypertension in obese patients


Authors: M. Souček
Published in: Kardiol Rev Int Med 2011, 13(1): 9-13
Category: From Hypertension to Heart Failure

Overview

Obesity and hypertension are two major cardiovascular risk factors that frequently occur together and increasingly influence the health of the population at large. The mutual relationship of the two is very well known, the actual cause of this relationship is not entirely clear. An increasing amount of evidence shows that an important role in the aetiology of hypertension in obese patients is played by increased activity in the sympathicus and activity in the ­renin-angiotensin-aldosterone system. The basic type of obesity on which we should focus in practice is obesity of the visceral type. Treatment of hypertension should start with treatment for obesity and an effort to reduce body mass and bring about a change in the patient’s lifestyle. In favourable cases it is possible, if not necessary, to support ­regimen procedures through the prescription of drugs from the so-called anti-obesic group. Unfortunately, these are currently few. A further option is bariatric surgery. We currently have little information at our disposal on the pharmacological treatment of hypertension in obese individuals and chiefly on its long-term ­effects. We therefore base the application of antihypertensive medication on general recommendations for the treatment of high blood pressure and the prevention of cardiovascular disease with regard to the known pathophysiological relationship between blood pressure and obesity.

Keywords:
hypertension – obesity – visceral fat – metabolic syndrome


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Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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