Obesity-Related Hypertension: An Emerging Clinical Phenotype

Obesity represents a pandemic, independent and modifiable cardiovascular risk factor, distinct from other well-known risk factors such as hypertension, hypercholesterolemia, and diabetes mellitus. The impact of this condition on cardiovascular outcomes is remarkably potentiated when obesity is associated with hypertension. These include the development and progression of left ventricular hypertrophy, endothelial dysfunction, sympathetic activation to the heart and peripheral vessels, impaired arterial distensibility, pro-atherogenic vascular alterations, and kidney dysfunction and failure. On the clinical ground, these alterations favor the development and progression of cardiovascular complications, such as coronary artery disease, chronic heart failure, life-threatening cardiac arrhythmias, cerebrovascular disease, and sleep apnea syndrome. In conclusion, the present paper will provide a comprehensive in-depth pathophysiological background, clinical consequences, and therapeutic implications of the obesity-related hypertensive phenotype.