Obesity-related hypertension: Role of the sympathetic nervous system, insulin, and leptin

Masuo, Kazuko

doi:10.1007/s11906-002-0035-0

Cited by 34 publications

(35 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12,17 The differences among the various studies might possibly be due to the multiple mechanisms and heterogeneous factors involved in the regulation of BP. 11,15,18 In the present study, fasting plasma insulin levels at entry were similar between those with and without weight gain and between those with and without BP elevation. However, the absolute increases in plasma insulin with weight gain were significantly greater in the group with significant weight gain and in the group with BP elevation whose BMI significantly increased.…”

Section: Discussionsupporting

confidence: 61%

“…18,19 However, the relation of insulin resistance and sympathetic nervous overactivity to hypertension and obesity is still controversial. 11,15,20 These and other investigations have documented the coexistence of elevated UA level, sympathetic overactivity, and hyperinsulinemia in hypertension and obesity, but the precise relation has not been clarified.The goal of the present longitudinal study was to clarify the interrelation of serum UA level, sympathetic activity, insulin, and leptin levels in subjects with weight gain-induced blood pressure (BP) elevation. We sequentially studied the accompaniments of spontaneous weight gain-induced BP elevation for 5 years, especially focusing on serum UA, sympathetic activity, and plasma levels of insulin and leptin.…”

mentioning

confidence: 97%

mentioning

confidence: 97%

See 2 more Smart Citations

Serum Uric Acid and Plasma Norepinephrine Concentrations Predict Subsequent Weight Gain and Blood Pressure Elevation

et al. 2003

Self Cite

View full text Add to dashboard Cite

Abstract-It has been reported that hypertension and obesity often coexist with hyperuricemia. To clarify the relations between serum uric acid, plasma norepinephrine, and insulin or leptin levels in subjects with weight gain-induced blood pressure elevation, we conducted the present longitudinal study. In 433 young, nonobese, normotensive men, body mass index, blood pressure, and levels of serum uric acid, fasting plasma norepinephrine, insulin, and leptin were measured every year for 5 years. Subjects were stratified by significant weight gain and/or blood pressure elevation (Ͼ10% in body mass index or mean blood pressure) for 5 years. At entry, blood pressure, uric acid, and norepinephrine values in subjects with blood pressure elevation were greater than in those without it, although body mass index, insulin, and leptin were similar. At entry, body mass index, blood pressure, uric acid, and norepinephrine in subjects with weight gain were greater than in those without weight gain. The increases in body mass index, mean blood pressure, uric acid, norepinephrine, insulin, and leptin for 5 years were greater in subjects with blood pressure elevation and/or weight gain than in subjects without, and those increases were greatest in subjects with weight gain whose blood pressure was elevated. By multiple regression analysis, basal mean blood pressure, norepinephrine, and uric acid were significant determinant factors of changes in mean blood pressure over 5 years, and basal body mass index, norepinephrine, and uric acid were significant determinant factors of changes in body mass index. These results demonstrate that serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation. Key Words: uric acid Ⅲ sympathetic nervous system Ⅲ obesity Ⅲ hypertension, obesity E levated serum uric acid (UA) is associated with increased rates of cardiovascular events, 1-3 and hyperuricemia is frequently observed in obese subjects and hypertensive patients. 4 -8 Several lines of evidence, both epidemiologic and clinical, point to a close interrelation between hyperuricemia, hypertension, and obesity. 2-8 Also, it is known that both hypertension and obesity are related to sympathetic overactivity, 9 -17 hyperinsulinemia, and insulin resistance. 18,19 However, the relation of insulin resistance and sympathetic nervous overactivity to hypertension and obesity is still controversial. 11,15,20 These and other investigations have documented the coexistence of elevated UA level, sympathetic overactivity, and hyperinsulinemia in hypertension and obesity, but the precise relation has not been clarified.The goal of the present longitudinal study was to clarify the interrelation of serum UA level, sympathetic activity, insulin, and leptin levels in subjects with weight gain-induced blood pressure (BP) elevation. We sequentially studied the accompaniments of spontaneous weight gain-induced BP elevation for 5 years, especially focusing on serum UA, sympathetic activity, and plasma levels of ...

show abstract

Section: Discussionsupporting

confidence: 61%

mentioning

confidence: 97%

See 1 more Smart Citation

Serum Uric Acid and Plasma Norepinephrine Concentrations Predict Subsequent Weight Gain and Blood Pressure Elevation

et al. 2003

Self Cite

View full text Add to dashboard Cite

show abstract

“…1,2,5,6 Furthermore, several large cohort studies have demonstrated close associations between obesity, especially abdominal obesity and the onset of chronic kidney disease (CKD) [7][8][9][10][11] and faster CKD progression. 10 Intentional weight loss (WL) reduced the risk of the onset and development of hypertension, 12,13 diabetes 14 and renal injury 15 in overweight or obese individuals.…”

Section: Introductionmentioning

confidence: 99%

“…Many large studies [24][25][26] have shown marked clinical benefits of lifestyle intervention, and modest WL, on the resolution of obesity-relate diseases including CKD as well as long-term benefits on all-cause mortality. In obese subjects, obesity-related glomerular hyperfiltration, 27 elevated sympathetic nervous activity, 12,13,[28][29][30] insulin resistance and stimulation of the renin-angiotensin-aldosterone system (RAS) 30,31 are ameliorated after WL.…”

Section: Introductionmentioning

confidence: 99%

Effects of weight loss on renal function in overweight Japanese men

et al. 2011

Self Cite

View full text Add to dashboard Cite

Obesity is known as an independent risk factor for renal injury. Sympathetic nerve activation may have an important role of the pathogenesis of obesity, and hypertension may underpin the development of cardiovascular events. In the present study, we evaluated the effects of weight loss (WL) on renal function, especially focusing on sympathetic nervous activity. In 154 overweight or obese Japanese men (89 normotensive and 65 untreated mild hypertensive subjects), body weight, body mass index (BMI), total body fat mass, blood pressure (BP), serum creatinine, blood urea nitrogen, creatinine clearance (CCr) (calculated with the Cockcroft-Gault equation) and plasma norepinephrine (NE) were measured before and after a 12-month period of WL with a mild caloric-restricted diet and exercise. A significant WL was defined as 10% or more WL compared with the entry period. In total, 97 (63.0%) subjects succeeded in significant (by 14.3%) WL at 12 months, and 57 subjects (37.0%) did not succeed in significant WL but they lost 7.7% weight. At entry, levels of plasma NE, serum creatinine and fat mass were significantly lower and CCr was greater in the group with a significant WL compared with those without WL. BMI, total body fat mass and plasma NE significantly decreased, and CCr increased with WL. At both baseline and at the 12-month period, fat mass and plasma NE negatively correlated with CCr and positively correlated with creatinine at each time point. Changes in fat mass and plasma NE over 12 months correlated with changes in creatinine, and only changes in fat mass negatively correlated with changes in CCr. Basal fat mass and plasma NE correlated positively with serum creatinine at 12 months and negatively with CCr at the same time point. In multiple regression analyses, basal plasma NE and fat mass were significant determinants of serum creatinine levels and CCr at 12 months.In conclusion, WL improved renal function (as evident from measures of creatinine and CCr) in overweight individuals. Basal plasma NE levels and total body fat mass could be predictors for improvement in renal function associated with WL. Suppression of sympathetic nervous activation associated with WL may have a role in the ameliorative effects on renal function.

show abstract

The role of the sympathetic nervous system in linking obesity with hypertension in white versus black Americans

Eslami¹,

Tuck²

2003

Current Science Inc

View full text Add to dashboard Cite

Several previous studies confirmed that obesity is a major risk factor for the development of cardiovascular diseases, including hypertension. A large number of clinical studies considered the role of the sympathetic nervous system in linking obesity with hypertension, and there is substantial evidence that human obesity is characterized by defects in sympathetic cardiovascular control. The association of obesity with hypertension has been well documented in most racial, ethnic, and socioeconomic groups. Ethnicity may be an important factor to consider since sympathetic nervous system activity, and the propensity for obesity and hypertension, all differ substantially among different populations. Obesity is actually accompanied by increased sympathetic nerve discharge to skeletal muscles, a main site for energy expenditure. Adiposity-related sympathetic overactivity is a compensatory mechanism to burn fat and decrease weight gain, but at the cost of increased sympathetic discharge to the peripheral vasculature, which could predispose to hypertension. Thus, sympathetic nervous system activity is important in the development and maintenance of obesity-related hypertension in different racial and ethnic populations, including white and black Americans.

show abstract

Obesity-related hypertension: Role of the sympathetic nervous system, insulin, and leptin

Cited by 34 publications

References 54 publications

Serum Uric Acid and Plasma Norepinephrine Concentrations Predict Subsequent Weight Gain and Blood Pressure Elevation

Serum Uric Acid and Plasma Norepinephrine Concentrations Predict Subsequent Weight Gain and Blood Pressure Elevation

Effects of weight loss on renal function in overweight Japanese men

The role of the sympathetic nervous system in linking obesity with hypertension in white versus black Americans

Contact Info

Product

Resources

About