Hypertension. 2003;41:625-633
Published online before print January 20, 2003, doi: 10.1161/01.HYP.0000052314.95497.78
Published online before print January 20, 2003, doi: 10.1161/01.HYP.0000052314.95497.78
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 2003;41:625.)
© 2003 American Heart Association, Inc.
Novartis Lectures |
The Kidney, Hypertension, and Obesity
From the Department of Physiology and Biophysics and Center of Excellence in Cardiovascular-Renal Research, The University of Mississippi Medical Center, Jackson.
Correspondence to Dr John E. Hall, University of Mississippi Medical Center, Department of Physiology and Biophysics, 2500 North State St, Jackson, MS 39216-4505. E-mail jehall{at}physiology.umsmed.edu
This paper provides a personal perspective of the role of abnormal renal-pressure natriuresis in the pathogenesis of hypertension. Direct support for a major role of renal-pressure natriuresis in long-term control of arterial pressure and sodium balance comes from studies demonstrating that (1) pressure natriuresis is impaired in all forms of chronic hypertension and (2) prevention of pressure natriuresis from operating, by servo-control of renal perfusion pressure, also prevents the maintenance of sodium balance hypertension. Although the precise mechanisms of impaired pressure natriuresis in essential hypertension have remained elusive, recent evidence suggests that obesity and overweight may play a major role. Obesity increases renal sodium reabsorption and impairs pressure natriuresis by activation of the renin-angiotensin and sympathetic nervous systems and by altered intrarenal physical forces. Chronic obesity also causes marked structural changes in the kidneys that eventually lead to a loss of nephron function, further increases in arterial pressure, and severe renal injury in some cases. Although there are many unanswered questions about the mechanisms of obesity hypertension and renal disease, this is one of the most promising areas for future research, especially in view of the growing, worldwide "epidemic" of obesity.
Key Words: blood pressure • sodium excretion • renin • angiotensin • sympathetic nervous system • renal disease
This article has been cited by other articles:
 |
|
 |
|
  A. Chagnac, M. Herman, B. Zingerman, A. Erman, B. Rozen-Zvi, J. Hirsh, and U. Gafter Obesity-induced glomerular hyperfiltration: its involvement in the pathogenesis of tubular sodium reabsorption Nephrol. Dial. Transplant., July 12, 2008; (2008) gfn379v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Calhoun, D. Jones, S. Textor, D. C. Goff, T. P. Murphy, R. D. Toto, A. White, W. C. Cushman, W. White, D. Sica, et al. Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research Circulation, June 24, 2008; 117(25): e510 - e526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Calhoun, D. Jones, S. Textor, D. C. Goff, T. P. Murphy, R. D. Toto, A. White, W. C. Cushman, W. White, D. Sica, et al. Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research Hypertension, June 1, 2008; 51(6): 1403 - 1419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Li, L. Chen, F. Yi, M. Xia, and P.-L. Li Salt-Sensitive Hypertension Induced by Decoy of Transcription Factor Hypoxia-Inducible Factor-1{alpha} in the Renal Medulla Circ. Res., May 9, 2008; 102(9): 1101 - 1108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. W. Krug and M. Ehrhart-Bornstein Aldosterone and Metabolic Syndrome: Is Increased Aldosterone in Metabolic Syndrome Patients an Additional Risk Factor? Hypertension, May 1, 2008; 51(5): 1252 - 1258. [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Griffin, H. Kramer, and A. K. Bidani Adverse renal consequences of obesity Am J Physiol Renal Physiol, April 1, 2008; 294(4): F685 - F696. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Zeng, I. Armando, Y. Luo, G. M. Eisner, R. A. Felder, and P. A. Jose Dysregulation of dopamine-dependent mechanisms as a determinant of hypertension: studies in dopamine receptor knockout mice Am J Physiol Heart Circ Physiol, February 1, 2008; 294(2): H551 - H569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. V. Wang and P. E. Scherer Adiponectin, Cardiovascular Function, and Hypertension Hypertension, January 1, 2008; 51(1): 8 - 14. [Full Text] [PDF]
|
|
|
|
 |
|
 C. B. Bucca, L. Brussino, A. Battisti, R. Mutani, G. Rolla, L. Mangiardi, and A. Cicolin Diuretics in Obstructive Sleep Apnea With Diastolic Heart Failure Chest, August 1, 2007; 132(2): 440 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. M.Y. Cheung and K. L. Ong Junctional Adhesion Molecule-1 May Have a Wider Role in Cardiovascular Disease Hypertension, August 1, 2007; 50(2): e22 - e22. [Full Text] [PDF]
|
|
|
|
|
|
H. Huang, C. Morisseau, J. Wang, T. Yang, J. R. Falck, B. D. Hammock, and M.-H. Wang Increasing or stabilizing renal epoxyeicosatrienoic acid production attenuates abnormal renal function and hypertension in obese rats Am J Physiol Renal Physiol, July 1, 2007; 293(1): F342 - F349. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L. Gentile, J. S. Orr, B. M. Davy, and K. P. Davy Modest weight gain is associated with sympathetic neural activation in nonobese humans Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2007; 292(5): R1834 - R1838. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Wang, I. Armando, L. D. Asico, C. Escano, X. Wang, Q. Lu, R. A. Felder, C. G. Schnackenberg, D. R. Sibley, G. M. Eisner, et al. The elevated blood pressure of human GRK4{gamma} A142V transgenic mice is not associated with increased ROS production Am J Physiol Heart Circ Physiol, May 1, 2007; 292(5): H2083 - H2092. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. G. Fuster, I. A. Bobulescu, J. Zhang, J. Wade, and O. W. Moe Characterization of the regulation of renal Na+/H+ exchanger NHE3 by insulin Am J Physiol Renal Physiol, February 1, 2007; 292(2): F577 - F585. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Li, F. Yi, C. M. Sundy, L. Chen, M. L. Hilliker, D. K. Donley, D. B. Muldoon, and P.-L. Li Expression and actions of HIF prolyl-4-hydroxylase in the rat kidneys Am J Physiol Renal Physiol, January 1, 2007; 292(1): F207 - F216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Li, F. Yi, E. A. dos Santos, D. K. Donley, and P.-L. Li Role of Renal Medullary Heme Oxygenase in the Regulation of Pressure Natriuresis and Arterial Blood Pressure Hypertension, January 1, 2007; 49(1): 148 - 154. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Whaley-Connell, N. A. Chowdhury, M. R. Hayden, C. S. Stump, J. Habibi, C. E. Wiedmeyer, P. E. Gallagher, E. Ann Tallant, S. A. Cooper, C. D. Link, et al. Oxidative stress and glomerular filtration barrier injury: role of the renin-angiotensin system in the Ren2 transgenic rat Am J Physiol Renal Physiol, December 1, 2006; 291(6): F1308 - F1314. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Song, C. K. Kost Jr., and D. S. Martin Androgens potentiate renal vascular responses to angiotensin II via amplification of the Rho kinase signaling pathway Cardiovasc Res, December 1, 2006; 72(3): 456 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Engeli, M. Boschmann, P. Frings, L. Beck, J. Janke, J. Titze, F. C. Luft, M. Heer, and J. Jordan Influence of Salt Intake on Renin-Angiotensin and Natriuretic Peptide System Genes in Human Adipose Tissue Hypertension, December 1, 2006; 48(6): 1103 - 1108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. I. Hallan, J. Coresh, B. C. Astor, A. Asberg, N. R. Powe, S. Romundstad, H. A. Hallan, S. Lydersen, and J. Holmen International Comparison of the Relationship of Chronic Kidney Disease Prevalence and ESRD Risk J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2275 - 2284. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Maeda, S. Jesmin, M. Iemitsu, T. Otsuki, T. Matsuo, K. Ohkawara, Y. Nakata, K. Tanaka, K. Goto, and T. Miyauchi Weight loss reduces plasma endothelin-1 concentration in obese men. Experimental Biology and Medicine, June 1, 2006; 231(6): 1044 - 1047. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Song, C. K. Kost Jr., and D. S. Martin Androgens augment renal vascular responses to ANG II in New Zealand genetically hypertensive rats Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2006; 290(6): R1608 - R1615. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Zhou, H. Huang, H.-H. Chang, J. Du, J. F. Wu, C.-Y. Wang, and M.-H. Wang Induction of Renal 20-Hydroxyeicosatetraenoic Acid by Clofibrate Attenuates High-Fat Diet-Induced Hypertension in Rats J. Pharmacol. Exp. Ther., April 1, 2006; 317(1): 11 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. da Silva, J. J. Kuo, L. S. Tallam, J. Liu, and J. E. Hall Does Obesity Induce Resistance to the Long-Term Cardiovascular and Metabolic Actions of Melanocortin 3/4 Receptor Activation? Hypertension, February 1, 2006; 47(2): 259 - 264. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Rahmouni, D. A. Morgan, G. M. Morgan, A. L. Mark, and W. G. Haynes Role of Selective Leptin Resistance in Diet-Induced Obesity Hypertension Diabetes, July 1, 2005; 54(7): 2012 - 2018. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Johnson, M. S. Segal, T. Srinivas, A. Ejaz, W. Mu, C. Roncal, L. G. Sanchez-Lozada, M. Gersch, B. Rodriguez-Iturbe, D.-H. Kang, et al. Essential Hypertension, Progressive Renal Disease, and Uric Acid: A Pathogenetic Link? J. Am. Soc. Nephrol., July 1, 2005; 16(7): 1909 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M Boustany, D. R. Brown, D. C. Randall, and L. A Cassis AT1-receptor antagonism reverses the blood pressure elevation associated with diet-induced obesity Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2005; 289(1): R181 - R186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Domrongkitchaiporn, P. Sritara, C. Kitiyakara, W. Stitchantrakul, V. Krittaphol, P. Lolekha, S. Cheepudomwit, and T. Yipintsoi Risk Factors for Development of Decreased Kidney Function in a Southeast Asian Population: A 12-Year Cohort Study J. Am. Soc. Nephrol., March 1, 2005; 16(3): 791 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Engeli, J. Bohnke, K. Gorzelniak, J. Janke, P. Schling, M. Bader, F. C. Luft, and A. M. Sharma Weight Loss and the Renin-Angiotensin-Aldosterone System Hypertension, March 1, 2005; 45(3): 356 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K A Brennan, G S Gopalakrishnan, L Kurlak, S M Rhind, C E Kyle, A N Brooks, M T Rae, D M Olson, T Stephenson, and M E Symonds Impact of maternal undernutrition and fetal number on glucocorticoid, growth hormone and insulin-like growth factor receptor mRNA abundance in the ovine fetal kidney Reproduction, February 1, 2005; 129(2): 151 - 159. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Trujillo, V. Ramirez, J. Perez, I. Torre-Villalvazo, N. Torres, A. R. Tovar, R. M. Munoz, N. Uribe, G. Gamba, and N. A. Bobadilla Renal protection by a soy diet in obese Zucker rats is associated with restoration of nitric oxide generation Am J Physiol Renal Physiol, January 1, 2005; 288(1): F108 - F116. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Rahmouni, M. L.G. Correia, W. G. Haynes, and A. L. Mark Obesity-Associated Hypertension: New Insights Into Mechanisms Hypertension, January 1, 2005; 45(1): 9 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Nielsen, J. R. Halliwill, M. J. Joyner, and M. D. Jensen Vascular Response to Angiotensin II in Upper Body Obesity Hypertension, October 1, 2004; 44(4): 435 - 441. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Philip-Couderc, F. Smih, J. E. Hall, A. Pathak, J. Roncalli, R. Harmancey, P. Massabuau, M. Galinier, P. Verwaerde, J.-M. Senard, et al. Kinetic analysis of cardiac transcriptome regulation during chronic high-fat diet in dogs Physiol Genomics, September 16, 2004; 19(1): 32 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. S. Gopalakrishnan, D. S. Gardner, S. M. Rhind, M. T. Rae, C. E. Kyle, A. N. Brooks, R. M. Walker, M. M. Ramsay, D. H. Keisler, T. Stephenson, et al. Programming of adult cardiovascular function after early maternal undernutrition in sheep Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2004; 287(1): R12 - R20. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Banday, T. Hussain, and M. F. Lokhandwala Renal dopamine D1 receptor dysfunction is acquired and not inherited in obese Zucker rats Am J Physiol Renal Physiol, July 1, 2004; 287(1): F109 - F116. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Sharma Is There a Rationale for Angiotensin Blockade in the Management of Obesity Hypertension? Hypertension, July 1, 2004; 44(1): 12 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. P. Davy and J. E. Hall Obesity and hypertension: two epidemics or one? Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2004; 286(5): R803 - R813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Pilz, J.-H. Brasen, W. Schneider, and F. C. Luft Obesity and Hypertension-Induced Restrictive Cardiomyopathy: A Harbinger of Things to Come Hypertension, May 1, 2004; 43(5): 911 - 917. [Full Text] [PDF]
|
|
|
|
|
|
B. Rodriguez-Iturbe, N. D. Vaziri, J. Herrera-Acosta, and R. J. Johnson Oxidative stress, renal infiltration of immune cells, and salt-sensitive hypertension: all for one and one for all Am J Physiol Renal Physiol, April 1, 2004; 286(4): F606 - F616. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Tsuda, I. Nishio, C. Vecchione, and G. Lembo Insulin, Leptin, and Membrane Microviscosity in Blood Pressure Regulation * Response: Insulin-Leptin Interplay May Differ Among Tissues Hypertension, April 1, 2004; 43(4): e15 - e16. [Full Text] [PDF]
|
|
|
|
|
|
T. L. Goodfriend and D. A. Calhoun Resistant Hypertension, Obesity, Sleep Apnea, and Aldosterone: Theory and Therapy Hypertension, March 1, 2004; 43(3): 518 - 524. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. Parkington, J. Dodd, S. E. Luff, K. Worthy, H. A. Coleman, M. Tare, W. P. Anderson, and A. J. Edgley Selective Increase in Renal Arcuate Innervation Density and Neurogenic Constriction in Chronic Angiotensin II-Infused Rats Hypertension, March 1, 2004; 43(3): 643 - 648. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Luke, A. Adeyemo, H. Kramer, T. Forrester, and R. S. Cooper Association Between Blood Pressure and Resting Energy Expenditure Independent of Body Size Hypertension, March 1, 2004; 43(3): 555 - 560. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. Wang, M. G. Larson, D. Levy, E. J. Benjamin, E. P. Leip, P. W.F. Wilson, and R. S. Vasan Impact of Obesity on Plasma Natriuretic Peptide Levels Circulation, February 10, 2004; 109(5): 594 - 600. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. F. DiBona The Sympathetic Nervous System and Hypertension: Recent Developments Hypertension, February 1, 2004; 43(2): 147 - 150. [Full Text] [PDF]
|
|
|
|
|
|
M. Trivedi, A. Marwaha, and M. Lokhandwala Rosiglitazone Restores G-Protein Coupling, Recruitment, and Function of Renal Dopamine D1A Receptor in Obese Zucker Rats Hypertension, February 1, 2004; 43(2): 376 - 382. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Forrester Historic and Early Life Origins of Hypertension in Africans J. Nutr., January 1, 2004; 134(1): 211 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. B. de Paula, A. A. da Silva, and J. E. Hall Aldosterone Antagonism Attenuates Obesity-Induced Hypertension and Glomerular Hyperfiltration Hypertension, January 1, 2004; 43(1): 41 - 47. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Harshfield, M. E. Wilson, K. McLeod, C. Hanevold, G. K. Kapuku, L. Mackey, D. Gillis, and L. Edmonds Adiposity Is Related to Gender Differences in Impaired Stress-Induced Pressure Natriuresis Hypertension, December 1, 2003; 42(6): 1082 - 1086. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-H. Wang, A. Smith, Y. Zhou, H.-H. Chang, S. Lin, X. Zhao, J. D. Imig, and A. M. Dorrance Downregulation of Renal CYP-Derived Eicosanoid Synthesis in Rats With Diet-Induced Hypertension Hypertension, October 1, 2003; 42(4): 594 - 599. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. G. Pickering Lifestyle Modification and Blood Pressure Control: Is the Glass Half Full or Half Empty? JAMA, April 23, 2003; 289(16): 2131 - 2132. [Full Text] [PDF]
|
|