Obesity and hypertension: It's about more than the numbers

This editorial comments on the recent Obesity Society and American Society of Hypertension joint position paper, justified by the substantial link between obesity and hypertension (HTN).

The editorial reviews the expert opinions. Other relevant clinical research is highlighted, such as an obesity paradox. Evidence-based lifestyle changes, drugs, and behavorial modification and newer agents are highlighted.

Areas of controversy are noted. Despite the importance of renin angiotensin system blockage, future federal guidelines may maintain thiazides as first choice, even with metabolic syndrome (MetS) and diabetes (DM). Chlorthalidone, 12.5-25 mg, has shown cardiovascular benefit, including with MetS and DM.

The conclusion calls for more research. However, the identification and elimination of racial/ethnic disparities should be addressed more explicitly. To better understand the obesity-hypertension linkage, curtail costs, and decrease premature disease and death, this excellent position paper is essential.