High plasma renin activity associates with obesity-related diabetes and arterial hypertension, and predicts persistent hypertension after bariatric surgery

Abstract

Background Information about the renin–angiotensin–aldosterone system (RAAS) in obese individuals before and after bariatric surgery is scarce. Aim of this study was to analyze the RAAS in severely obese subjects, in relation to anthropometric and metabolic variables, with special reference to glucose tolerance. Methods 239 subjects were evaluated at baseline, and 181 one year after bariatric surgery [laparoscopic gastric banding (LAGB)]. Results At baseline, renin (plasma renin activity, PRA) was increased from normal to glucose tolerance and more in diabetes, also correlating with ferritin. After LAGB, the decrease of PRA and aldosterone was significant in hypertensive, but not in normotensive subjects, and correlatied with decrease of ferritin. PRA and glucose levels were predictive of persistent hypertension 1 year after LAGB. Conclusions These data support the role of RAAS in the pathophysiology of glucose homeostasis, and in the regulation of blood pressure in obesity. Ferritin, as a proxy of subclinical inflammation, could be another factor contributing to the cross-talk between RAAS and glucose metabolism.

An investigation into the correlation of vitamin D status and management outcomes in patients with severe COVID-19 at a South African tertiary hospital

“…The increased renin activity in VitD deficiency leads to upregulation of ACE2 activity, which in turn increases the conversion of angiotensin I to angiotensin II; the latter has been postulated to be toxic to the lungs through its action on angiotensin II type I receptors, causing severe inflammation and lung fibrosis [37] . Plasma renin is also elevated in those with hypertension and diabetes mellitus, and in most elderly patients [38] . This common thread of hyper-reninaemia between these conditions and VitD inadequacy may possibly be one of the underlying physiological mechanisms leading to the high risk of severe COVID-19 seen in patients with these comorbidities.…”

Additive Effects of Obesity on Myocardial Microcirculation and Left Ventricular Deformation in Essential Hypertension: A Contrast-Enhanced Cardiac Magnetic Resonance Imaging Study

“…These results suggest that subclinical systolic dysfunction caused by hypertension was further aggravated with obesity. This may be attributed to interrelated factors such as various neurohormonal and metabolic abnormalities, abnormalities in microvasculature and cardiac remodeling ( 4 ). In addition, these results also indicate that CMR-FT technique allows for early detection of subclinical systolic dysfunction, thus enabling timely intervention to prevent disease progression.…”

“…Hypertension and obesity are well-recognized global health concerns, and the two conditions often coexist ( 1 – 3 ). Both hypertension and obesity are associated with an increased risk of cardiovascular morbidity and mortality in isolation, and when combined the cardiovascular risk increases ( 4 ). Myocardial microcirculatory damage is an important mechanism of myocardial impairment ( 5 ) that is associated with cardiac dysfunction ( 6 ), poor prognosis ( 7 ), and adverse outcomes ( 8 ).…”

Relationship between socioeconomic status and hypertension incidence among adults in southwest China: a population-based cohort study

“…The biopsychosocial (BPS) model [ 8 ] has highlighted that the development of hypertension is solely determined by biological factors such as obesity [ 9 , 10 ] and blood lipid levels [ 11 ], but can also be influenced by behavioral patterns, lifestyle choices [ 12 – 14 ], and external environmental factors including economic status, level of education, professional and other factors [ 7 , 15 ]. There is a growing awareness among individuals that socioeconomic status (SES) plays a substantial role in the occurrence of hypertension, particularly in light of the rapid evolution of social economies.…”