Vnitr Lek 2009, 55(Suppl 1):13-18

Hypertension therapy in obese patients

M. Souček

II. interní klinika Lékařské fakulty MU a FN u sv. Anny Brno, přednosta prof. MUDr. Miroslav Souček, CSc.

Inter-relationship between hypertension and obesity is very well known although the actual grounds for this linkage are not clear. There is growing evidence to support the role of increased sympathetic nervous system activity and involvement of the RAAS in aetiology of hypertension in obese patients. Visceral obesity is the type of obesity we should focus on in clinical practice. Treatment of hypertension should start with the treatment of obesity aiming at body weight reduction and changes to the lifestyle. Where indicated, lifestyle changes could, or even should, be supported with an anti-obesity agent. Positive effect of lifestyle management as well as anti-obesity agents on blood pressure reduction in obese patients has been established. Unfortunately, information about pharmacological management of hypertension in obese patients and its long-term effects in particular, is lacking. Therefore, when antihypertensives are prescribed, general recommendations for high blood pressure management and prevention of cardiovascular diseases should be followed, taking into account the so far known details of pathophysiological relationship between high blood pressure and obesity.

Keywords: hypertension; obesity; visceral fat; metabolic syndrome

Received: April 20, 2009; Published: February 1, 2009  Show citation