(Hypertension. 2000;35:807.)
© 2000 American Heart Association, Inc.
Scientific Contributions |
Overweight and Hypertension
A 2-Way Street?
From the Division of Hypertension (S.J., M.V.), University of Michigan Health System, Ann Arbor; and Dipartimento di Medicina Clinica e Sperimentale (P.P.), University of Padova, Padova, Italy.
Correspondence to Stevo Julius, MD, Department of Internal Medicine, Division of Hypertension, 3918 Taubman Center, The University of Michigan Medical Center, Ann Arbor, MI 48109-0356. E-mail sjulius{at}umich.edu
Abstract—Cross-sectionally, higher weight is associated with higher blood pressure levels; prospectively, baseline weight and weight gain predict higher blood pressure. The loss of weight is frequently associated with a decrease in blood pressure. These findings suggest that weight gain may pathophysiologically contribute to blood pressure elevation. In this review, we present data to indicate that the reverse is also true; persons of equal weight who had higher initial blood pressures gain more weight in the future. We also propose a plausible hypothesis to explain this reverse relationship. Both the blood pressure elevation and the gain of weight may reflect a primary increase in sympathetic tone. It is well known that in a milieu of increased sympathetic tone, the ß-adrenergic responsiveness decreases. Sympathetic overactivity and decreased cardiovascular ß-adrenergic responsiveness have been described in hypertension. ß-Adrenergic receptors mediate increases in energy expenditure. If these metabolic receptors were downregulated in hypertension, the ability of hypertensive patients to dissipate calories would decrease and they would gain more weight. The possible relationship of decreased ß-adrenergic responsiveness to weight in hypertension can be experimentally tested. Such research may contribute to an explanation of why patients with hypertension can rarely lose weight. An understanding of this pathophysiological relationship may open new avenues for therapeutic interventions.
Key Words: obesity • hypertension, obesity • sympathetic nervous system • adrenergic receptors
This article has been cited by other articles:
 |
|
 |
|
  A. V. Agapitov, M. L. d. G. Correia, C. A. Sinkey, and W. G. Haynes Dissociation Between Sympathetic Nerve Traffic and Sympathetically Mediated Vascular Tone in Normotensive Human Obesity Hypertension, October 1, 2008; 52(4): 687 - 695. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Sachs-Ericsson, A. B. Burns, K. H. Gordon, L. A. Eckel, S. A. Wonderlich, R. D. Crosby, and D. G. Blazer Body Mass Index and Depressive Symptoms in Older Adults: The Moderating Roles of Race, Sex, and Socioeconomic Status Am J Geriatr Psychiatry, September 1, 2007; 15(9): 815 - 825. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Landa, S. I. Garcia, M. L. Schuman, A. Burgueno, A. L. Alvarez, F. E. Saravia, C. Gemma, and C. J. Pirola Knocking down the diencephalic thyrotropin-releasing hormone precursor gene normalizes obesity-induced hypertension in the rat Am J Physiol Endocrinol Metab, May 1, 2007; 292(5): E1388 - E1394. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Narkiewicz Obesity and hypertension--the issue is more complex than we thought Nephrol. Dial. Transplant., February 1, 2006; 21(2): 264 - 267. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Nussinovitch, K. Elishkevitz, T. Rosenthal, and M. Nussinovitch Screening for Hypertension in High School Clinical Pediatrics, October 1, 2005; 44(8): 711 - 714. [Abstract] [PDF]
|
|
|
|
|
|
E. Lurbe, I. Torro, V. Alvarez, T. Nawrot, R. Paya, J. Redon, and J. A. Staessen Prevalence, Persistence, and Clinical Significance of Masked Hypertension in Youth Hypertension, April 1, 2005; 45(4): 493 - 498. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Seals and C. Bell Chronic Sympathetic Activation: Consequence and Cause of Age-Associated Obesity? Diabetes, February 1, 2004; 53(2): 276 - 284. [Abstract] [Full Text]
|
|
|
|
 |
|
 D. Gustafson, E. Rothenberg, K. Blennow, B. Steen, and I. Skoog An 18-Year Follow-up of Overweight and Risk of Alzheimer Disease Arch Intern Med, July 14, 2003; 163(13): 1524 - 1528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Castellano, F. Rossi, M. Giacche, C. Perani, F. Rivadossi, M. L. Muiesan, M. Salvetti, M. Beschi, D. Rizzoni, and E. Agabiti-Rosei {beta}2-Adrenergic Receptor Gene Polymorphism, Age, and Cardiovascular Phenotypes Hypertension, February 1, 2003; 41(2): 361 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kazumi, A. Kawaguchi, K. Sakai, T. Hirano, and G. Yoshino Young Men With High-Normal Blood Pressure Have Lower Serum Adiponectin, Smaller LDL Size, and Higher Elevated Heart Rate Than Those With Optimal Blood Pressure Diabetes Care, June 1, 2002; 25(6): 971 - 976. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. I. Garcia, M. S. Landa, P. I. Porto, A. L. Alvarez, M. Schuman, S. Finkielman, and C. J. Pirola Thyrotropin-Releasing Hormone Decreases Leptin and Mediates the Leptin-Induced Pressor Effect Hypertension, February 1, 2002; 39(2): 491 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Vecchione, A. Maffei, S. Colella, A. Aretini, R. Poulet, G. Frati, M. T. Gentile, L. Fratta, V. Trimarco, B. Trimarco, et al. Leptin Effect on Endothelial Nitric Oxide Is Mediated Through Akt-Endothelial Nitric Oxide Synthase Phosphorylation Pathway Diabetes, January 1, 2002; 51(1): 168 - 173. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Kumpusalo, J. K. Takala, and A. M. Sharma Do {beta}-Blockers Put on Weight? Response Hypertension, July 1, 2001; e5(1): . [Full Text] [PDF]
|
|