Treatment of hypertension in obese patients
Comte-Perret, S.; Giusti, V.; Wuerzner, G.ég.
Revue Medicale Suisse 9(397): 1622; 1624-1626
2013
ISSN/ISBN: 1660-9379 PMID: 24073473 Document Number: 666411
Prevalence of obesity and hypertension has increased these last decades. Around 60 to 70% of the incidence of hypertension is related to obesity. The relationship between obesity and hypertension is now well established. The sympathetic nervous system and the renin-angiotensin-aldosterone (RAA) system are activated in obese patients, mostly by insulin, and predispose the kidney to reabsorb sodium and water. In obese patients with hypertension, it is recommended to target a blood pressure < 140/90 mmHg. Lifestyle changes (weight loss, physical activity, low-salt diets) are useful to decrease blood pressure but are difficult to maintain in the long-term. When drugs are necessary, drugs that are metabolically neutral should be used, and often need to be combined to other drug classes in order to achieve blood pressure target.