Obesity, metabolic syndrome, and primary hypertension

Abstract

Primary hypertension is the dominant form of arterial hypertension in adolescents. Disturbed body composition with, among other things, increased visceral fat deposition, accelerated biological maturation, metabolic abnormalities typical for metabolic syndrome, and increased adrenergic drive constitutes the intermediary phenotype of primary hypertension. Metabolic syndrome is observed in 15–20% of adolescents with primary hypertension. These features are also typical of obesity-related hypertension. Metabolic abnormalities and metabolic syndrome are closely associated with both the severity of hypertension and the risk of target organ damage. However, even though increased body mass index is the main determinant of blood pressure in the general population, not every hypertensive adolescent is obese and not every obese patient suffers from hypertension or metabolic abnormalities typical for metabolic syndrome. Thus, the concepts of metabolically healthy obesity, normal weight metabolically unhealthy, and metabolically unhealthy obese phenotypes have been developed. The risk of hypertension and hypertensive target organ damage increases with exposure to metabolic risk factors which are determined by disturbed body composition and visceral obesity. Due to the fact that both primary hypertension and obesity-related hypertension present similar pathogenesis, the principles of treatment are the same and are focused not only on lowering blood pressure, but also on normalizing body composition and metabolic abnormalities.

The Role of Short-Chain Fatty Acids of Gut Microbiota Origin in Hypertension

“…According to epidemiological and animal data analyses, hypertension and other metabolic disorders, such as diabetes and obesity, have an extremely close and reciprocal causal relationship ( Velarde and Berk, 2005 ; Katsimardou et al, 2020 ; Litwin and Kulaga, 2021 ). The role of SCFAs in obesity and metabolic regulation (glucose and lipid metabolism) has attracted increasing attention, and these metabolites may indirectly regulate blood pressure by participating in metabolism ( Figure 4 ; Frampton et al, 2020 ; He et al, 2020 ; Machate et al, 2020 ).…”

Design, Synthesis, and Structure‐Activity Relationship Study of Pyrazolones as Potent Inhibitors of Pancreatic Lipase

“…Obesity is a multifactorial disease defined as a long‐term energy in take over consumption, resulting in excessive energy stored in the body in the form of fat (adipose tissue) [1] . Being obese increases the risk of many diseases and health conditions, including type 2 diabetes, [2] coronary heart disease (CHD), [3] dyslipidemia, [4] hypertension, [5] nonalcoholic fatty liver, [6,7] sleep apnea [8,9] . As rates of obesity have soared over the past two decades, it is increasingly clear that the number of people who cannot achieve and maintain a healthy weight is not limited to adults, but also includes children [10] .…”

Association of Helicobacter pylori infection with the risk of metabolic syndrome and insulin resistance: an updated systematic review and meta-analysis

“…The definition of metabolic syndrome in this study was also based on its international definition, i.e. people who have risk factors such as dyslipidemia (elevated triglycerides and apolipoprotein B -containing lipoproteins, and low high-density lipoproteins (HDL)), elevation of arterial blood pressure (BP) and dysregulated glucose homeostasis, while abdominal obesity and/or insulin resistance (IR) [ 45 , 46 ]. In addition, metabolic syndrome was considered according to the National Cholesterol Education Program—Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF) criteria [ 24 , 47 ].…”