PMID: 9534095Apr 16, 1998Paper

Obesity in hypertension: effects on prognosis and treatment

Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension
N M Kaplan

Abstract

OBESITY AND RISK OF MORBIDITY: Obesity is becoming an increasingly important factor in the pathogenesis of hypertension, dyslipidemia and diabetes, which together with hyperinsulinemia comprise the deadly quartet of the insulin resistance syndrome. Obesity in the absence of these other factors is only a minor risk factor, but most obesity is accompanied by one or more of these, worsening the prognosis. The presence of obesity complicates the management of hypertension, probably in large part because of the concomitant insulin resistance which adds to the pathogenetic mechanisms and subtracts from the therapeutic efficacy of many antihypertensive regimens. Unfortunately, some of the agents used to reduce obesity may further aggravate the problem through their stimulation of sympathetic nervous activity. Nonetheless, in the treatment of hypertension in most obese patients who have relatively little excess risk, attempts to reduce body weight should be attempted first, through sensible dietary restrictions, increased aerobic exercise and judicious use of non-hypertensinogenic appetite suppressants. Thereby, additional motivation to lose weight may be provided by the potential of escaping or at least delaying antihypertensive drug ...Continue Reading

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