Obesity and hypertension

El‐Atat, Fadi; Aneja, Ashish; McFarlane, Samy I.; Sowers, James R.

doi:10.1016/s0889-8529(03)00070-7

Cited by 77 publications

(102 citation statements)

References 165 publications

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“…Obesity by itself possibly accounts for 78% and 65% of essential hypertension in men and women, respectively, according to data from the Framingham Cohort (19). Animal experiments and human studies have confirmed this causation and given insight into the mechanisms involved (3)(4)(5)14).…”

Section: Visceral Obesitymentioning

confidence: 96%

“…Visceral obesity triggers a litany of maladaptive cardiovascular, renal, metabolic, prothrombotic and inflammatory responses, some of which form the "cardio-metabolic syndrome" (Table1; Figure 2) (3)(4)(5)14). These responses, including hyperinsulinemia/insulin resistance, dysglycemia, dyslipidemia, hyperleptinemia, hypercortisolemia, altered vascular structure and function, enhanced SNS and renin-angiotensin-aldosterone system (RAAS) activities, hypercoagulability, and an altered Kallikrein-Kinin system, individually and interdependently, contribute to progressive renal disease/ESRD, hypertension, and other CVD morbidity and mortality ( Figure 7) (3)(4)(5)16).…”

Section: Visceral Obesitymentioning

confidence: 99%

“…These responses, including hyperinsulinemia/insulin resistance, dysglycemia, dyslipidemia, hyperleptinemia, hypercortisolemia, altered vascular structure and function, enhanced SNS and renin-angiotensin-aldosterone system (RAAS) activities, hypercoagulability, and an altered Kallikrein-Kinin system, individually and interdependently, contribute to progressive renal disease/ESRD, hypertension, and other CVD morbidity and mortality ( Figure 7) (3)(4)(5)16). In fact, the parallel increase in the prevalence of obesity and ESRD suggests that obesity is one of the most important precursors of ESRD (4) (Figure 4).…”

Section: Visceral Obesitymentioning

confidence: 99%

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The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease

El‐Atat

Stas²,

McFarlane³

et al. 2004

Journal of the American Society of Nephrology

174

136

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Abstract. The incidence of end-stage renal disease (ESRD) has risen dramatically in the past decade, mainly due to the increasing prevalence of diabetes mellitus, and both impaired glucose tolerance and hypertension are important contributors to rising rates of ESRD. Obesity, especially the visceral type, is associated with peripheral resistance to insulin actions and hyperinsulinemia, which predisposes to development of diabetes. A common genetic predisposition to insulin resistance and hypertension and the coexistence of these two disorders predisposes to premature atherosclerosis. A constellation of metabolic and cardiovascular derangements, which also includes dyslipidemia, dysglycemia, endothelial dysfunction, fibrinolytic and inflammatory abnormalities, left ventricular hypertrophy, microalbuminuria, and increased oxidative stress, is referred to as the cardiometabolic syndrome.

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Section: Visceral Obesitymentioning

confidence: 96%

Section: Visceral Obesitymentioning

confidence: 99%

Section: Visceral Obesitymentioning

confidence: 99%

See 1 more Smart Citation

The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease

El‐Atat

Stas²,

McFarlane³

et al. 2004

Journal of the American Society of Nephrology

174

136

View full text Add to dashboard Cite

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“…Usually, these characteristics are rather associated with higher prevalence and lower control of high BP. 6 The data presented here suggest that better control rate can be explained by intensification of treatment in the Caribbean's. Caribbean patients were more likely to be treated and more likely to receive many medications.…”

mentioning

confidence: 65%

Prescribing practices in the management of hypertension in the Caribbean's

et al. 2006

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“…It is now known that obesity causes hypertension through multiple mechanisms, including hyperinsulinemia, renal injuries, increased sympathetic activity, and enhanced salt sensitivity. 7 Do these results imply that other cardiovascular risk factors, such as dyslipidemia and diabetes, are not important mediators of obesity and CVD? The answer is no.…”

mentioning

confidence: 99%

Overweight and Increased Cardiovascular Mortality

2005

Hypertension

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O besity has reached epidemic proportions in the United States. Currently, one third of US adults are classified as obese and another one third as overweight. Obesity is also a growing epidemic in other parts of the world. The French, who have enjoyed relatively low rates of obesity and cardiovascular disease (CVD), are also experiencing expanding waistlines. 1 Although the health hazards of obesity are widely recognized, the relationship between the middle range of body mass index (BMI) values and mortality is less clear because epidemiologic studies have found linear and curve-linear relationships between BMI and mortality. However, epidemiologic studies of BMI and mortality have been fraught with methodologic problems, including failure to control for cigarette smoking; inappropriate control of biologic effects of obesity, such as hypertension and hyperglycemia; and failure to consider weight loss attributable to subclinical diseases. 2 These biases have led to the typical J-or U-shaped relationship between BMI and mortality seen in many epidemiologic studies and to a systematic underestimate of the impact of obesity on premature mortality. For example, in a recent analysis of NHANES (National Health and Nutrition Examination Survey) data sets, Flegal et al 3 found that excess mortality attributable to obesity was much lower than reported previously, and that being overweight was associated with a lower mortality compared with normal weight. However, these findings are most likely the result of artifact attributable to the methodologic flaws mentioned above. In particular, the study failed to exclude persons from the analyses who had chronic diseases at baseline and did not adequately control for smoking, leading to artificially elevated mortality among the lean subjects. Nonetheless, these findings have caused a great deal of confusion among the general public, and commercial interest groups have attempted to exploit the study and dismiss obesity as a public health issue. 4 In the current issue of the Hypertension, Thomas et al 5 evaluated the impact of overweight on cardiovascular mortality in a large French population (139 562 men and 104 236 women). During an average of 14 years of follow-up, they documented 11 688 deaths (2949 from CVD) among men and 4188 deaths (929 from CVD) among women. This is a self-selected population who came for a health checkup, with a mean age of 43 years for men and 41 years for women and mean BMI values of 24.6 for men and 22.8 for women. The prevalence of overweight and obesity combined was 42% in men and 21% in women. The prevalence of obesity was quite low (Ϸ5% in both genders). This large and relatively young population provides a unique opportunity to examine the impact of overweight on cardiovascular mortality.Two major findings emerged from these analyses. First, in age-adjusted analyses, increasing BMI was strongly associated with increased cardiovascular morality, but the association became nonsignificant after adjusting for cardiovascular risk factors such as hypert...

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Obesity and hypertension

Cited by 77 publications

References 165 publications

The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease

The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease

Prescribing practices in the management of hypertension in the Caribbean's

Overweight and Increased Cardiovascular Mortality

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