Obesity, metabolic syndrome, and primary hypertension

Primary hypertension is the dominant form of arterial hypertension in adolescents. Disturbed body composition with, among other things, increased visceral fat deposition, accelerated biological maturation, metabolic abnormalities typical for metabolic syndrome, and increased adrenergic drive constitutes the intermediary phenotype of primary hypertension. Metabolic syndrome is observed in 15-20% of adolescents with primary hypertension. These features are also typical of obesity-related hypertension. Metabolic abnormalities and metabolic syndrome are closely associated with both the severity of hypertension and the risk of target organ damage. However, even though increased body mass index is the main determinant of blood pressure in the general population, not every hypertensive adolescent is obese and not every obese patient suffers from hypertension or metabolic abnormalities typical for metabolic syndrome. Thus, the concepts of metabolically healthy obesity, normal weight metabolically unhealthy, and metabolically unhealthy obese phenotypes have been developed. The risk of hypertension and hypertensive target organ damage increases with exposure to metabolic risk factors which are determined by disturbed body composition and visceral obesity. Due to the fact that both primary hypertension and obesity-related hypertension present similar pathogenesis, the principles of treatment are the same and are focused not only on lowering blood pressure, but also on normalizing body composition and metabolic abnormalities.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:36

Enthalten in:

Pediatric nephrology (Berlin, Germany) - 36(2021), 4 vom: 01. Apr., Seite 825-837

Sprache:

Englisch

Beteiligte Personen:

Litwin, Mieczysław [VerfasserIn]
Kułaga, Zbigniew [VerfasserIn]

Links:

Volltext

Themen:

Adolescence
Journal Article
Metabolic syndrome
Metabolically healthy obesity
Metabolically unhealthy obesity
Obesity-related hypertension
Primary hypertension

Anmerkungen:

Date Completed 09.02.2022

Date Revised 09.02.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00467-020-04579-3

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM309717868