European Society of Hypertension Working Group on Obesity Obesity-induced hypertension and target organ damage: current knowledge and future directions

Schlaich, Markus P.; Lambert, Gavin W.; Straznicky, Nora E.; Esler, Murray; Dixon, John; Lambert, Elisabeth; Redón, Josep; Jordan, Jens

doi:10.1097/hjh.0b013e32831dafaf

Cited by 38 publications

(22 citation statements)

References 67 publications

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“…Moreover, elevated SNA may accelerate the progression of end organ damage (vascular, metabolic, cardiac, renal), independently of any rise in arterial pressure (AP) (Lambert et al, 2010a;Schlaich et al, 2009;Fisher et al, 2009). Thus, SNA may also contribute to the co-morbidities of insulin resistance, type II diabetes mellitus, obstructive sleep apnea, and cardiovascular disease commonly present in obese individuals.…”

Section: Introductionmentioning

confidence: 99%

Obesity-induced increases in sympathetic nerve activity: Sex matters

Brooks

Shi

Holwerda

et al. 2015

Autonomic Neuroscience

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Abundant evidence obtained largely from male human and animal subjects indicates that obesity increases sympathetic nerve activity (SNA), which contributes to hypertension development. However, recent studies that included women reported that the strong relationships between muscle SNA and waist circumference or body mass index (BMI) found in men are not present in overweight and obese women. A similar sex difference in the association between adiposity and hypertension development has been identified in animal models of obesity. In this brief review, we consider two possible mechanisms for this sex difference. First, visceral adiposity, leptin, insulin, and angiotensin II have been identified as potential culprits in obesity-induced sympathoexcitation in males. We explore if these factors wield the same impact in females. Second, we consider if sex differences in vascular reactivity to sympathetic activation contribute. Our survey of the literature suggests that premenopausal females may be able to resist obesity-induced sympathoexcitation and hypertension in part due to differences in adipose disposition as well as its muted inflammatory response and reduced production of pressor versus depressor components of the renin-angiotensin system. In addition, vascular responsiveness to increased SNA may be reduced. However, more importantly, we identify the urgent need for further study, not only of sex differences per se, but also of the mechanisms that may mediate these differences. This information is required not only to refine treatment options for obese premenopausal women but also to potentially reveal new therapeutic avenues in obese men and women.

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Section: Introductionmentioning

confidence: 99%

Obesity-induced increases in sympathetic nerve activity: Sex matters

Brooks

Shi

Holwerda

et al. 2015

Autonomic Neuroscience

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“…The effect of weight loss on blood pressure control is variable and may not be durable. 58 Hypercholesterolemia is not a comorbidity of severe obesity. Total cholesterol and low-density lipoprotein cholesterol levels are actually lower with increasing BMI Ͼ35 kg/m 2 , and weight loss alone has little effect on these levels.…”

Section: Health Outcomes Comorbiditymentioning

confidence: 99%

Laparoscopic Adjustable Gastric Banding and Other Devices for the Management of Obesity

et al. 2012

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“…6 The growing incidence and prevalence of obesity across developed economies worldwide (obesity "epidemic") has an enormous impact on increasing cardiovascular risk. 16,17 Obesity is frequently associated with increased systemic oxidative stress/inflammation, 18 -20 as suggested by the observation of an increased production of circulating indicators, such as C-reactive protein, tumoral necrosis factor-␣, and interleukin 6. 18 -20 However, few data are presently available about the structure of small arteries in obese patients, in particular in those without the concomitant presence of diabetes mellitus and/or hypertension.…”

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confidence: 99%

Effects of Weight Loss on Structural and Functional Alterations of Subcutaneous Small Arteries in Obese Patients

et al. 2011

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Abstract-Structural alterations of subcutaneous small resistance arteries, as indicated by an increased media:lumen ratio, are frequently present in hypertensive and/or diabetic patients and may represent the earliest alteration observed. In addition, media:lumen ratios of small arteries have a strong prognostic significance. However, no data are available about the structure of small resistance arteries of obese patients, particularly after weight loss. We have investigated 27 patients with severe obesity. Twelve of them were normotensive, and 15 were hypertensive. All of the obese patients underwent bariatric surgery. We compared results obtained with those observed in 13 normotensive lean controls and in 13 hypertensive lean patients. All of the subjects and patients underwent a biopsy of subcutaneous fat during surgical intervention. In 8 obese patients, a second biopsy was obtained after consistent weight loss, during a surgical intervention for abdominoplasty. Subcutaneous small resistance arteries were dissected and mounted on a wire myograph, and structural parameters were measured. A concentration-response curve to acetylcholine was performed to evaluate endothelial function. Obese patients, independent from the presence of hypertension, show the presence of an increased media:lumen ratio and media cross-sectional area, together with an impaired endothelial-dependent vasodilatation. After surgical correction of obesity and consistent weight loss, a significant improvement of microvascular structure and of some oxidative stress/inflammation markers were observed. In conclusion, our data suggest that the presence of obesity is associated with structural alterations of subcutaneous small resistance arteries, mainly characterized by hypertrophic remodeling. Weight loss may improve microvascular structure. (Hypertension. 2011;58:29-36.)Key Words: remodeling Ⅲ hypertension Ⅲ obesity Ⅲ microcirculation Ⅲ small arteries A lterations in the microcirculation are common accompaniments of cardiovascular and metabolic diseases 1,2 and may involve small resistance arteries, arterioles, capillaries, and postcapillary venules. 3 In particular, the structure of subcutaneous 1-3 and cerebral 4 small resistance arteries (lumen diameter: 100 to 300 m) may be altered in the presence of cardiovascular or metabolic diseases. Essential hypertension is associated with a narrowing of the internal lumen and with an increase of media wall thickness, with consequent increase in the media:lumen ratio. 1 The observed increase in the media:lumen ratio may be the consequence of an eutrophic remodeling (rearrangement of otherwise normal material around a narrowed lumen) or of a hypertrophic remodeling (vascular smooth muscle cell hypertrophy or hyperplasia). 5 Eutrophic remodeling of subcutaneous small arteries is commonly seen in essential hypertension, whereas an inward hypertrophic remodeling, with evident smooth muscle cell growth, was shown in patients with type 2 diabetes mellitus, regardless of the presence of elevated or normal ...

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European Society of Hypertension Working Group on Obesity Obesity-induced hypertension and target organ damage: current knowledge and future directions

Cited by 38 publications

References 67 publications

Obesity-induced increases in sympathetic nerve activity: Sex matters

Obesity-induced increases in sympathetic nerve activity: Sex matters

Laparoscopic Adjustable Gastric Banding and Other Devices for the Management of Obesity

Effects of Weight Loss on Structural and Functional Alterations of Subcutaneous Small Arteries in Obese Patients

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