73% of individuals in the US are categorised as overweight or obese, according to the Centres for Disease Control and Prevention (CDC). At the same time, hypertension (high blood pressure) affects roughly half of individuals.
According to research, obesity and hypertension often occur together. In fact, according to the American Heart Association (AHA), obesity is to blame for 78% of instances of hypertension in men and 65% of cases in women.
Due to their close ties to a number of potentially fatal conditions, such as heart attack and stroke, obesity and hypertension—defined by the 2017 American College of Cardiology/American Heart Association Task Force as blood pressure higher than 130/80—represent significant public health issues.
CAUSES OF OBESITY
What Causes Obesity?
Less than 5% of the time, medical conditions including hypothyroidism (insufficient production of thyroid hormone), growth hormone deficit (insufficient production of growth hormone), or Cushing’s illness (in which the body overproduces steroid hormones) can cause people to become obese. Additionally, some drugs could make you gain weight. Corticosteroids, antidepressants, and treatments for epilepsy are some of these medications.
However, calorie excess, or simply taking in more calories than you burn, is the most typical reason for obesity.
The energy worth of food is often measured in calories. The extra calories that you take in but don’t expend via exercise are stored as fat by your body. Weight gain results from eating more calories than you expend. Weight increase like this.
OBESE VS. OVERWEIGHT
Defining Obesity and Overweight
In general, the terms overweight and obese describe weight that’s higher than what experts consider to be healthy. Most medical professionals use body mass index (BMI) as a screening tool. A high BMI generally means you have excess body fat, though there are cases where this isn’t true.
BMI in the 18.5 to 24.9 range is considered healthy weight. BMI of 25 to 29.9 is considered overweight, and 30 or higher indicates obesity.
RISKS OF HYPERTENSION
What Other Conditions Can Hypertension Lead To?
Hypertension has a wide-ranging impact on the body. It can negatively affect not only your heart, but your brain, blood sugar levels, and more. Some of the most serious health issues affecting people with hypertension include:
Heart attack
Heart failure
Stroke
Cognitive decline/dementia
Erectile dysfunction
Insulin resistance
Kidney disease
Loss of vision
Metabolic syndrome
Peripheral artery disease
OBESITY AND HYPERTENSION
How Does Obesity Lead to Hypertension?
Researchers believe that obesity leads to high blood pressure in three ways:
Physical compression of the kidneys (renal compression) by the surrounding fat
Increased sympathetic nervous system activity
Activation of the renin-angiotensin-aldosterone system (RAAS)
Renal Compression
Your kidneys perform a variety of complex and important functions that keep your whole body in balance. When it comes to blood pressure specifically, your kidneys release hormones and control the flow of nutrients, such as calcium, potassium, and sodium. All of these functions work together to keep blood pressure normal and regulated.
Too much visceral fat around the kidneys—which often happens with obesity—can compress these vital organs. This leads to higher intrarenal pressure, which causes the kidneys to hold on to too much sodium. This ultimately leads to water retention, then high blood pressure.
Sympathetic Nervous System Overactivity
Your sympathetic nervous system is part of your autonomic nervous system, which controls functions such as heart rate, blood pressure, digestion, and sweating. The sympathetic nervous system is best known for controlling the fight-or-flight response—your body’s reaction to dangerous or stressful situations.
When you sense a possible threat, your body’s sympathetic nervous system activates. It calls on your adrenal glands to release hormones like adrenaline and cortisol. These hormones cause the pupils to dilate, the skin to get clammy or sweaty, digestion to slow, heart rate and blood pressure to spike, and muscles to twitch—all to help you deal with a threat (fight) or escape a potentially deadly situation (flight).
People who have chronically higher cortisol levels—either due to stress, alcoholism, or other health conditions—have been shown to go on to develop abdominal obesity. In turn, obesity in the abdominal area is often associated with higher long-term cortisol levels. Researchers think that this creates a vicious cycle, with increased cortisol levels contributing to obesity and obesity contributing to increased cortisol levels.
An overactive sympathetic nervous system directly and indirectly contributes to elevated blood pressure, including through stimulation of the renin-angiotensin-aldosterone system.
Renin-Angiotensin-Aldosterone System
The renin-angiotensin-aldosterone system (RAAS) is a series of reactions that controls blood pressure and blood volume.
Renin is an enzyme (a protein that triggers chemical reactions). Angiotensin and aldosterone are hormones (chemicals that send messages throughout the body). Together, these substances work to keep your blood pressure in a normal range by regulating water and sodium retention along with blood vessel constriction. Here’s how:
When blood pressure drops, the kidneys release renin, which splits a protein called angiotensinogen into two pieces.
One of these two, angiotensin I, is important to this process. Once it’s formed, it’s then split again by angiotensin-converting enzyme (ACE).
One of the resulting pieces is angiotensin II. This hormone causes arteries to constrict, raising blood pressure. It also triggers the release of aldosterone, causing the kidneys to hold on to sodium and excrete potassium. The higher your sodium, the more water you retain—which raises blood pressure and blood volume.
Both kidney compression and overstimulation of the sympathetic nervous system are thought to activate RAAS, thereby increasing blood pressure.
THE ROLE OF LEPTIN
Obesity, Leptin Resistance, and High Blood Pressure
Leptin, the hormone that suppresses appetite and tells your body to stop eating when you’re full, also contributes to obesity-related hypertension. It does this by activating the sympathetic nervous system, but it also has an influence at the kidney level.
According to H. Joseph Blair, M.D., an internal medicine specialist in Saginaw, MI, people with obesity have very high leptin levels, yet they don’t reduce their intake of food.
“Somehow the appetite is not suppressed, and this is called leptin resistance,” he says. “Other effects of leptin are to increase sympathetic nervous activity and blood pressure. It activates sympathetic nerve activity to the kidney, too, which also increases arterial blood pressure.”
METABOLIC SYNDROME
Obesity, Insulin Resistance, and High Blood Pressure
Obesity, insulin resistance, and hypertension are all linked via metabolic syndrome—a cluster of factors that increase the risk of diabetes, heart disease, and stroke. If you have at least three of the five following factors, you likely have metabolic syndrome:
Abdominal obesity: Waist circumference of 35+ inches in women and 40+ inches in men
Hypertension
High blood glucose levels
High triglycerides
Low HDL (beneficial) cholesterol
Most people who have metabolic syndrome also have insulin resistance, as obesity makes the cells less responsive to insulin. They don’t take up glucose as effectively, causing sugar to build up in the bloodstream. If your body can’t make enough insulin for your cells to properly respond and start moving glucose, you could end up with type 2 diabetes.
TREATING HYPERTENSION
How Is Hypertension Treated in People With Obesity?
Regardless of whether your weight is normal or high, hypertension is a serious condition that must be addressed. If you have obesity, losing excess weight is the most important step you can take to improve your blood pressure numbers.
Along with weight loss, some of the best lifestyle changes to treat hypertension include:
Limit (or eliminate) alcohol intake.
Quit smoking.
Get plenty of sleep every night. Seven to nine hours is a good range to strive for.
Reduce stress. Any kind of stress initiates the fight-or-flight response, spiking your blood pressure. Some good stress-busting techniques include professional therapy, yoga, deep breathing, meditation, visualization, and exercise.
Exercise. It’s not what a lot of people want to hear, but exercise is imperative in not only reducing obesity but also getting blood pressure back into a healthy range. Fortunately, you don’t have to do anything fancy or expensive. Something as simple as walking can have a major positive impact on blood pressure. Some research indicates that routine walking can lower systolic (top number) blood pressure by 4.11 mmHg and diastolic (bottom number) blood pressure by 1.79 mmHg.
Diet is also critically important for blood pressure management. For most, this means reducing salt intake.
Focus your diet on whole, fresh foods, including lean meats and poultry, fruits and vegetables, unsalted nuts and seeds, whole grains, and heart-healthy fats like avocado and olive oil. Avoid high-sodium foods, heavily processed and fast food, and sugar.
If your blood pressure is dangerously high, you may need medication to help lower it. There are many different categories of hypertension medication. ACE inhibitors and angiotensin II receptor blockers work on mechanisms in the RAAS. Other types include diuretics, beta blockers, alpha blockers, vasodilators, and central antagonists. Your health care provider will work with you to find the drug that provides the best results for you with the fewest side effects.
Finally, for people who have class III obesity, defined as a BMI above 40, bariatric (weight loss) surgery may be an option. No operation is easy—and this is certainly true for weight loss surgery.
Bariatric procedures alter your digestive system, limiting how much you can eat and/or reducing your body’s ability to absorb nutrients. Even though the weight loss is rapid, these surgeries come with long-term risks and side effects to your digestive and bowel tracts and even lungs. Most surgeons require a lot of personal counseling and education before approving these procedures.
CONCLUSION
Bottom Line
Neither obesity nor hypertension should be taken lightly, and if you have both, it is even more important to start making changes to reverse these conditions. If you don’t know where to start, begin by going for regular 15-minute walks. Each and every positive lifestyle change can lead to more healthy habits. In addition to lifestyle changes, talk to your doctor about whether you are a candidate for medical treatment (medication) for obesity, hypertension, or both.
How Obesity and Hypertension Are Related
73% of individuals in the US are categorised as overweight or obese, according to the Centres for Disease Control and Prevention (CDC). At the same time, hypertension (high blood pressure) affects roughly half of individuals.
According to research, obesity and hypertension often occur together. In fact, according to the American Heart Association (AHA), obesity is to blame for 78% of instances of hypertension in men and 65% of cases in women.
Due to their close ties to a number of potentially fatal conditions, such as heart attack and stroke, obesity and hypertension—defined by the 2017 American College of Cardiology/American Heart Association Task Force as blood pressure higher than 130/80—represent significant public health issues.
CAUSES OF OBESITY
What Causes Obesity?
Less than 5% of the time, medical conditions including hypothyroidism (insufficient production of thyroid hormone), growth hormone deficit (insufficient production of growth hormone), or Cushing’s illness (in which the body overproduces steroid hormones) can cause people to become obese. Additionally, some drugs could make you gain weight. Corticosteroids, antidepressants, and treatments for epilepsy are some of these medications.
However, calorie excess, or simply taking in more calories than you burn, is the most typical reason for obesity.
The energy worth of food is often measured in calories. The extra calories that you take in but don’t expend via exercise are stored as fat by your body. Weight gain results from eating more calories than you expend. Weight increase like this.
OBESE VS. OVERWEIGHT
Defining Obesity and Overweight
In general, the terms overweight and obese describe weight that’s higher than what experts consider to be healthy. Most medical professionals use body mass index (BMI) as a screening tool. A high BMI generally means you have excess body fat, though there are cases where this isn’t true.
BMI in the 18.5 to 24.9 range is considered healthy weight. BMI of 25 to 29.9 is considered overweight, and 30 or higher indicates obesity.
RISKS OF HYPERTENSION
What Other Conditions Can Hypertension Lead To?
Hypertension has a wide-ranging impact on the body. It can negatively affect not only your heart, but your brain, blood sugar levels, and more. Some of the most serious health issues affecting people with hypertension include:
OBESITY AND HYPERTENSION
How Does Obesity Lead to Hypertension?
Researchers believe that obesity leads to high blood pressure in three ways:
Renal Compression
Your kidneys perform a variety of complex and important functions that keep your whole body in balance. When it comes to blood pressure specifically, your kidneys release hormones and control the flow of nutrients, such as calcium, potassium, and sodium. All of these functions work together to keep blood pressure normal and regulated.
Too much visceral fat around the kidneys—which often happens with obesity—can compress these vital organs. This leads to higher intrarenal pressure, which causes the kidneys to hold on to too much sodium. This ultimately leads to water retention, then high blood pressure.
Sympathetic Nervous System Overactivity
Your sympathetic nervous system is part of your autonomic nervous system, which controls functions such as heart rate, blood pressure, digestion, and sweating. The sympathetic nervous system is best known for controlling the fight-or-flight response—your body’s reaction to dangerous or stressful situations.
When you sense a possible threat, your body’s sympathetic nervous system activates. It calls on your adrenal glands to release hormones like adrenaline and cortisol. These hormones cause the pupils to dilate, the skin to get clammy or sweaty, digestion to slow, heart rate and blood pressure to spike, and muscles to twitch—all to help you deal with a threat (fight) or escape a potentially deadly situation (flight).
People who have chronically higher cortisol levels—either due to stress, alcoholism, or other health conditions—have been shown to go on to develop abdominal obesity. In turn, obesity in the abdominal area is often associated with higher long-term cortisol levels. Researchers think that this creates a vicious cycle, with increased cortisol levels contributing to obesity and obesity contributing to increased cortisol levels.
An overactive sympathetic nervous system directly and indirectly contributes to elevated blood pressure, including through stimulation of the renin-angiotensin-aldosterone system.
Renin-Angiotensin-Aldosterone System
The renin-angiotensin-aldosterone system (RAAS) is a series of reactions that controls blood pressure and blood volume.
Renin is an enzyme (a protein that triggers chemical reactions). Angiotensin and aldosterone are hormones (chemicals that send messages throughout the body). Together, these substances work to keep your blood pressure in a normal range by regulating water and sodium retention along with blood vessel constriction. Here’s how:
THE ROLE OF LEPTIN
Obesity, Leptin Resistance, and High Blood Pressure
Leptin, the hormone that suppresses appetite and tells your body to stop eating when you’re full, also contributes to obesity-related hypertension. It does this by activating the sympathetic nervous system, but it also has an influence at the kidney level.
According to H. Joseph Blair, M.D., an internal medicine specialist in Saginaw, MI, people with obesity have very high leptin levels, yet they don’t reduce their intake of food.
“Somehow the appetite is not suppressed, and this is called leptin resistance,” he says. “Other effects of leptin are to increase sympathetic nervous activity and blood pressure. It activates sympathetic nerve activity to the kidney, too, which also increases arterial blood pressure.”
METABOLIC SYNDROME
Obesity, Insulin Resistance, and High Blood Pressure
Obesity, insulin resistance, and hypertension are all linked via metabolic syndrome—a cluster of factors that increase the risk of diabetes, heart disease, and stroke. If you have at least three of the five following factors, you likely have metabolic syndrome:
Most people who have metabolic syndrome also have insulin resistance, as obesity makes the cells less responsive to insulin. They don’t take up glucose as effectively, causing sugar to build up in the bloodstream. If your body can’t make enough insulin for your cells to properly respond and start moving glucose, you could end up with type 2 diabetes.
TREATING HYPERTENSION
How Is Hypertension Treated in People With Obesity?
Regardless of whether your weight is normal or high, hypertension is a serious condition that must be addressed. If you have obesity, losing excess weight is the most important step you can take to improve your blood pressure numbers.
Along with weight loss, some of the best lifestyle changes to treat hypertension include:
Diet is also critically important for blood pressure management. For most, this means reducing salt intake.
Focus your diet on whole, fresh foods, including lean meats and poultry, fruits and vegetables, unsalted nuts and seeds, whole grains, and heart-healthy fats like avocado and olive oil. Avoid high-sodium foods, heavily processed and fast food, and sugar.
If your blood pressure is dangerously high, you may need medication to help lower it. There are many different categories of hypertension medication. ACE inhibitors and angiotensin II receptor blockers work on mechanisms in the RAAS. Other types include diuretics, beta blockers, alpha blockers, vasodilators, and central antagonists. Your health care provider will work with you to find the drug that provides the best results for you with the fewest side effects.
Finally, for people who have class III obesity, defined as a BMI above 40, bariatric (weight loss) surgery may be an option. No operation is easy—and this is certainly true for weight loss surgery.
Bariatric procedures alter your digestive system, limiting how much you can eat and/or reducing your body’s ability to absorb nutrients. Even though the weight loss is rapid, these surgeries come with long-term risks and side effects to your digestive and bowel tracts and even lungs. Most surgeons require a lot of personal counseling and education before approving these procedures.
CONCLUSION
Bottom Line
Neither obesity nor hypertension should be taken lightly, and if you have both, it is even more important to start making changes to reverse these conditions. If you don’t know where to start, begin by going for regular 15-minute walks. Each and every positive lifestyle change can lead to more healthy habits. In addition to lifestyle changes, talk to your doctor about whether you are a candidate for medical treatment (medication) for obesity, hypertension, or both.
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