Diversity of hypertension in obesity

Abstract

Induced hypertension (HTN) is one of the HTN types, the pathogenetic mecha­nisms of which are well studied: its main cause lies in the dysfunction of visceral adipose tissue, which leads to renin-angiotensin-aldosterone system activation, imbalance of the sympathetic and parasympathetic systems, renal involvement, and then to vascular endothelium dysfunction and, in fact, to an increase in blood pressure and HTN consolidation. However, within this HTN form, some mechanisms can be distinguished that, in obesity, play a special role. This review describes such additional mechanisms as chronic inflammation, excessive salt intake, dys­biosis, environmental factors. Understanding these HTN features in obesity has es­sential for achieving target blood pressure levels. In addition, the review pays special attention to such HTN forms in obesity as masked and nocturnal, the timely diagnosis of which is extremely important for the timely initiation of therapy and improving the prognosis.