Therapeutic Considerations in the Treatment of Obesity Hypertension

Marion R. Wofford, MD, MPH; Margaret Miller Davis, MD; Kimberly G. Harkins, MD; Deborah S. King, PharmD; Sharon B. Wyatt, PhD, RN, CS; Daniel W. Jones, MD

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Abstract and Introduction

Obesity, now recognized as an independent risk factor for cardiovascular disease, is closely associated with hypertension. Complex mechanisms link increasing body weight with increasing blood pressure. Treatment of the obese patient with hypertension requires consideration of physiologic changes related to obesity hypertension. Lifestyle modification, including weight reduction and increased physical activity, can directly influence blood pressure levels and improve blood pressure control in obese, hypertensive patients. Clinical trials are needed to determine the most effective antihypertensive drugs for the obese, hypertensive patient. Antiobesity drugs offer viable adjunctive pharmacotherapy for obesity hypertension, but additional long-term studies are needed to support their safety and efficacy.

Increasing body weight has long been associated with increasing blood pressure.[1] Epidemiologic and longitudinal studies demonstrate the link between obesity and hypertension, yet these comorbid conditions occur in a large and growing segment of the population in the industrialized world. Obesity, now recognized as an independent risk factor for cardiovascular disease (CVD),[2] is strongly associated with other risk factors, including hypertension.[3] The mechanisms relating obesity to hypertension are complex, and the treatment of hypertension among obese individuals is challenging for patients and health care providers alike.

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