Hypertension, which can be brought on by obesity, raises the risk of disability and mortality. A hormone called leptin is released into the bloodstream by fat tissue, and it sends messages to the hypothalamus, a region of the brain. Leptin levels rise in tandem with an increase in fat stores, signalling that the body has enough stored energy.
According to a recent study done on mice, obesity-related elevations in leptin levels may also stimulate the formation of blood vessels in the hypothalamus, which in turn results in hypertension. Obesity is a risk factor for atherosclerosis, which involves the constriction and stiffness of arteries and frequently results in hypertension, according to scientists and other healthcare professionals.
They are less knowledgeable about how obesity affects the small blood arteries in the brain and other parts of the body, though. A recent study suggests that one of the causes of hypertension in obese individuals may be related to the aberrant proliferation of tiny blood vessels in a specific area of the brain. Obesity-related elevated risks of mortality and disability are known to be influenced by both types of injury — to the big and small vessels. In the hypothalamus, a region of the brain that controls appetite and blood pressure, consuming a high-calorie meal causes the formation of small blood vessels, according to earlier study in mice and people.
Obesity raises your risk of developing a number of diseases, such as heart disease, diabetes, and hypertension. It’s important to remember that weight discrimination has negative health impacts as well.
Blood flows through your arteries more forcefully than usual when you have hypertension, also known as high blood pressure. High blood pressure can result in heart disease, according to the Centers for Disease Control and Prevention (CDC).
- Cardiac issues
- Stroke
- Renal illness
- Cognition and brain issues
- Increased chance of dementia
Adults with high blood pressure make up about 47% of the population, and those 65 and over make up 70%. Only 1 in 4 people have it under control, and up to 1 in 3 people are unaware that they even have it.
Can being obese lead to hypertension?
Hypertension can be brought on by obesity or made worse if you already have it. According to an analysis from 2020, obesity causes 65 to 78 percent of main hypertension patients. Having more fat tissue in the body might result in complicated alterations that work together to either cause or exacerbate hypertension. These alterations include:
- Overactivity of the sympathetic nervous system
- RAAS (renin-angiotensin-aldosterone) system stimulation
- Alterations in cytokines produced by fat (hormones)
- Insulin sensitivity
- Modifications to the kidneys’ structure and function
- Overweight versus obesity
The quantity of fat cells is what distinguishes obesity from overweight. Body mass index is used by doctors to assess this (BMI). The proportion of your weight to height is known as your BMI. A BMI of 25 to 29.9 is considered overweight by the Centers for Disease Control and Prevention (CDC). Obesity is defined as a BMI of 30 or greater.
Are you uncertain of your BMI?
However, because it doesn’t take into account how people carry their weight, BMI isn’t necessarily the best indicator of obesity. You may be particularly vulnerable to difficulties if you have a lot of visceral fat, or fat that is carried about your belly. Some researchers believe that your waist size serves as a more accurate predictor.
According to studies, being obese or overweight increases the likelihood of developing hypertension. Additionally, the risk rises as BMI does. In a 2018 European study involving over 7,000 participants, the prevalence of hypertension rose as BMI rose. There was hypertension in:
- Participants with “normal” BMI made about 45% of the group
- 79 to 87 percent of those who had obesity and 67 percent of people who were overweight
Hypertension brought on by obesity
Numerous factors, including obesity, can either induce or aggravate hypertension. Because of various associated medical issues, obesity can make it more challenging to treat hypertension.
The following are some of the methods by which obesity develops or aggravates hypertension:
- Altered hormone signalling altered sympathetic nervous system activity, a component of the autonomic nervous system in control of the fight-or-flight response, altered kidney anatomy and function
- Visceral fat, or the fat around the midsection, is carried by more persons who are obese. Visceral fat surrounds, presses against, and places additional strain on the abdominal organs and cardiovascular system.
- According to 2015 research, this additional pressure frequently causes resistant hypertension, or uncontrolled blood pressure
- Despite taking three or more blood pressure drugs, you may trust this source.
- System of renin-angiotensin-aldosterone
According to a 2017 analysis, the RAAS system may be one of the causes of high blood pressure. Your entire body’s blood pressure and volume are controlled by the RAAS. Blood pressure can stay high for a very long time when the RAAS system is malfunctioning.
According to another evaluation of 2017, obesity raises the levels of every hormone in the RAAS. High blood pressure results from this imbalance.
Neurological system of sympathy
The body’s autonomic nervous system includes the sympathetic nervous system. The fight-or-flight system is a common name for it. Your metabolism and heart health are significantly impacted by it.
According to 2015 research, storing a lot of fat, especially visceral, results in increased amounts of several hormones being produced. This system becomes overactive as a result of these hormones, which can harm organs and increase insulin resistance.
Kidney compression
The pressure on the kidneys rises when one has a lot of body fat. The kidneys are in charge of eliminating extra water from the body and managing salt levels, which aids in controlling blood pressure. Your kidneys become less effective at absorbing and excreting water and salt when squeezed for an extended period of time.
2019 research indicates that obese people’s kidneys also require a higher-than-average blood flow to function effectively. Blood pressure is raised as a result.
Resistance to leptin
By signalling to your body that you are satisfied, the hormone leptin helps you feel less hungry. You can maintain a healthy weight by doing this. Leptin resistance exists in some persons, particularly in those who are obese. They have enough of leptin in their bodies, but because their bodies can’t properly utilise it, it doesn’t make them feel satisfied.
Leptin resistance makes it more probable for people to eat a lot and still feel hungry, which can result in weight gain. Leptin tolerance develops as your body becomes more accustomed to its effects, which is part of the issue. Leptin may have an impact on your blood pressure, according to research from 2016. Hypertension may result from leptin’s inability to function effectively in your body.
Resistance to insulin
Type 2 diabetes and prediabetes are two illnesses that can occasionally be brought on by obesity. The hormone insulin, which is produced by the pancreas, enables your cells to take up sugar and use it as fuel. Your cells won’t react to insulin the way they should if you have insulin resistance. For the same result, more insulin is required.
In type 2 diabetes, your pancreas overworks itself over time and is unable to produce enough insulin to control your blood sugar levels. A 2014 study found that having high blood sugar levels over an extended period of time can harm or stiffen arteries. This causes high blood pressure or makes it worse.
How is hypertension managed in obese people?
Managing your weight and blood pressure while reversing or attenuating these physical changes is extremely doable. Doctors’ main course of treatment for both illnesses is weight loss. They frequently suggest food and lifestyle modifications, occasionally in conjunction with bariatric or weight loss surgery.
Typically, medical professionals mix weight loss (with or without surgery) with other treatments, such as drugs. Doctors advise making significant lifestyle changes to maintain your weight because drugs can have side effects. Regular medical exams are essential.
Medications
To assist manage hypertension brought on by obesity, doctors might prescribe a number of drugs. In the event that one drug doesn’t work, doctors may substitute another.
Antihypertensive drugs can be divided into nine types based on how they affect your body. On an individual basis, doctors might also think about recommending weight loss drugs. When someone is obese, some drugs work better than others.
Surgery
Typically, doctors who treat obesity offer advice on modifying one’s lifestyle. They’ll advise cutting back on salt, coffee, and alcohol in your diet. They’ll also promote increased physical activity.
But making and maintaining these improvements over time can be challenging. Or, to reduce your risk of serious complications, you might need to lose a significant amount of weight quickly. In that case, your doctor might also advise weight-loss surgery. This is supposed to assist you in losing enough weight, claims a 2020 review from Trusted Source.
Especially if you have another related condition or a BMI over 40, the American Heart Association recommends surgery to help treat obesity-related hypertension. In 63 percent of patients who underwent metabolic surgery, according to their review of studies, high blood pressure was completely cured. After surgery, even more people were able to cut back on blood pressure-lowering medication.
Review of 2019 examined the four types of metabolic surgery that are currently carried out in the US:
- Biliopancreatic diversion with duodenal switch
- Adjustable gastric banding
- Sleeve gastrectomy and
- Gastric bypass
All of these procedures make your stomach smaller, which reduces the amount of food you can consume. You can’t fully absorb what you’ve eaten because the second two also skip through some of the intestine.
Changes in lifestyle to manage obese-hypertension
To achieve and keep a healthy weight, significant lifestyle adjustments are necessary. Lean mass must be maintained while fat mass is decreased.
These alterations include:
- Eating a calorie-controlled, healthful diet
- Lowering the caffeine
- Taking up exercise by regularly engaging in an activity you enjoy
- Getting a good night’s sleep abstaining from drinking too much alcohol
- If you do smoke, stop, and stay away from secondhand smoke smoke
- Reducing tension
- Obtaining assistance from relatives and friends while monitoring blood pressure at home
- Changes in diet
Doctors may suggest a low-calorie diet to patients with obesity and hypertension. This ranges from 500 to 1,500 calories per day for men and from 500 to 1,200 calories per day for women, according to research from 2016. They ought to also: reduce their intake of saturated fats and cholesterol by consuming less salt, both added salt and the kind found in many processed foods, and by consuming more water, fruits, fresh and raw vegetables, fish, lean meats, and whole grains.
Final words
Depending on the country and area, hypertension prevalence varies. The WHO Region of the Americas has the lowest prevalence of hypertension while the WHO African Region has the greatest prevalence of hypertension (both at 27%).
The number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015, with the growth noted mostly in low- and middle-income nations. This increase is mostly caused by an increase in risk factors for hypertension in those groups.