The Role of Sympatho-Inhibition in Combination Treatment of Obesity-Related Hypertension

Obesity-related hypertension is commonly characterized by increased sympathetic nerve activity and is therefore acknowledged as a predominantly neurogenic form of hypertension. The sustained sympatho-excitation not only contributes to the rise in blood pressure but also elicits a vicious cycle which...

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Bibliographic Details
Published in:Current hypertension reports 2017-12, Vol.19 (12), p.99-7, Article 99
Main Authors: Carnagarin, Revathy, Gregory, Cynthia, Azzam, Omar, Hillis, Graham S., Schultz, Carl, Watts, Gerald F., Bell, Damon, Matthews, Vance, Schlaich, Markus P.
Format: Article
Language:English
Subjects:
Antihypertensive Agents: Mechanisms of Drug Action (ME Ernst
Blood pressure
Cardiology
Family Medicine
General Practice
Hypertension
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Nephrology
Obesity
Primary Care Medicine
Section Editor
Topical Collection on Antihypertensive Agents: Mechanisms of Drug Action
Weight control
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Summary:Obesity-related hypertension is commonly characterized by increased sympathetic nerve activity and is therefore acknowledged as a predominantly neurogenic form of hypertension. The sustained sympatho-excitation not only contributes to the rise in blood pressure but also elicits a vicious cycle which facilitates further weight gain and progression of associated co-morbidities. While weight loss and exercise remain at the forefront of therapy for obesity and obesity-related hypertension, the difficulties in achieving and maintaining long-term weight loss with lifestyle measures and the variable blood pressure response to weight loss often necessitate prescription of antihypertensive drug therapy. Remarkably, there are no specific recommendations for pharmacologic treatment for obese patients with arterial hypertension in any of the current guidelines and general principles of antihypertensive treatment are applied. The use of β-blockers and diuretics is commonly discouraged as first- or second-line therapy due to their unfavorable metabolic effects. This review explores evolving therapeutic strategies which based on their interference with pathophysiologic mechanism relevant in the context of obesity may guide optimized treatment of obesity-related hypertension.
ISSN:1522-6417
1534-3111
DOI:10.1007/s11906-017-0795-1