Abstract
Obesity-related hypertension is a metabolic disease, part of metabolic syndrome based on visceral adipose tissue accumulation and associated hyperinsulinemia. Obesity is a cause of hypertension in about 60% of cases and there is a 3.5-fold relative risk for hypertension in obese people.
More than one half patients with grade 3 obesity are hypertensive. The pathophysiology of obesity-related hypertension includes high levels of adipokines and increased intra-abdominal pressure.
The diagnostic criteria for obesity-related hypertension are not different and treatment is based on the same principles, only with a greater emphasis on ACE inhibitors and ARB drugs. Beta blockers are relatively contraindicated and diuretics are to be used with caution.
All options to reduce the excess weight must be utilized, including bariatric-metabolic surgery if indicated.