Professional Documents
Culture Documents
• Weight Loss
• No Weight Change
The situation is critical due to the fact that the diseases that can occur
due to obesity are becoming increasingly prevalent, particulary
cardiovascular disease, currently the leading cause of mortality
worldwide
Xie D, Bollag WB. Obesity, Hypertension and Aldosterone:is Leptin the link?. J Endocrinol. 2016; 230: 7-11.
The Obesity Epidemic
40
35,2
35 34,0
33,1
30 28,1
Percent of Population
26,0
25
20,6
Over
20 the last 3 decades, mean BMI has increased
16,8 17,1
15,7
15 by12,20.412,8kg/m2 per decade worlwide
10,7
10
0
Men Women
RISKESDAS 2018
Adverse effect of Obesity
RISKESDAS 2018
There is a link between
obesity and hypertension
Obesity-Related Hypertension
44
40 38.2 39.3
30.8
30 27.3 28.9
24 25.3
22.3
20 17.6 16.4
10.1 12.2
10 9
5.7
1.7 4.2
0
<18.5 18.5-24.9 25-26.9 27-29.9 30-34.9 35-39.9 40 OVERALL
Kotchen TA. Obesity-Related Hypertension: Epidemiology, Pathophysiology, and Clinical Management. Am J Hypertens. 2010; 11(23): 1170-8
Rahmouni K et al. J Hypertens. 2005; 45: 9-14.
Pathogenesis of Obesity-Related Hypertension
Leggio M, lombardi M, caldarone E, et al. The Relationship Between obesity and Hypertension: an Updated Comprehensive overview on vicious twins.
Hypertens Res. 2017; 40: 947-63.
Srikanthan K et al. Int J. Med. Sci. 2016; 13: 26.
➢Introduction
➢Obesity and Hypertension
➢Treatment of Obesity-Related Hypertension
➢Summary
Therapy for obesity-related hypertension for
the most part follows the standar line of high
blood pressure treatment but perhaps with the
greater emphasis on healthy lifestyle
Non-pharmacological treatment
• Adoption of healthy lifestyle
• The core tenets of a healthy lifestyle as it relates to
maintenance of a normal body weight include
sufficient levels of physical activity and consuming a
nutritious, calorically balanced diet.
Leggio M et al. Hypertens Res. 2017; 40: 947-63.
• Systematic reviews consistently report a decrease in SBP
of about 1 mmHg per kg of weight loss with follow-up of
2-3 years.
• There is attenuation in the long term, with a decrease of
about 6 mmHg in SBP per 10 kg of weight loss.
DeMarco VG, Aroor AR, Sowers JR. The Pathophysiology of Hypertension in Patients With Obesity. Nat Rev Endocrinol. 2014; 10(6): 364-76.
➢Introduction
➢Obesity and Hypertension
➢Treatment of Obesity-Related Hypertension
➢Summary
• Obesity and Hypertension is an important
public health issue
• Obesity is a risk factor for hypertension
• Obesity-related hypertension can occur via
multiple mechanisms:insulin resistance,
inflammation, inappropiate SNS and RAAS
activation, structural and functional
abnormalities in the kidney and
vasculature
• Treating Hypertension in obese requires
adressing the obesity as part of the
therapeutic plan