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The Role of Aldosterone in Obesity-Related Hypertension
#MMPMID26927805
Kawarazaki W
; Fujita T
Am J Hypertens
2016[Apr]; 29
(4
): 415-23
PMID26927805
show ga
Obese subjects often have hypertension and related cardiovascular and renal
diseases, and this has become a serious worldwide health problem. In obese
subjects, impaired renal-pressure natriuresis causes sodium retention, leading to
the development of salt-sensitive hypertension. Physical compression of the
kidneys by visceral fat and activation of the sympathetic nervous system,
renin-angiotensin systems (RAS), and aldosterone/mineralocorticoid receptor (MR)
system are involved in this mechanism. Obese subjects often exhibit
hyperaldosteronism, with increased salt sensitivity of blood pressure (BP).
Adipose tissue excretes aldosterone-releasing factors, thereby stimulating
aldosterone secretion independently of the systemic RAS, and aldosterone/MR
activation plays a key role in the development of hypertension and organ damage
in obesity. In obese subjects, both salt sensitivity of BP, enhanced by
obesity-related metabolic disorders including aldosterone excess, and increased
dietary sodium intake are closely related to the incidence of hypertension. Some
salt sensitivity-related gene variants affect the risk of obesity, and together
with salt intake, its combination is possibly associated with the development of
hypertension in obese subjects. With high salt levels common in modern diets,
salt restriction and weight control are undoubtedly important. However, not only
MR blockade but also new diagnostic modalities and therapies targeting and
modifying genes that are related to salt sensitivity, obesity, or RAS regulation
are expected to prevent obesity and obesity-related hypertension.
|*Blood Pressure
[MESH]
|Aldosterone/*metabolism
[MESH]
|Animals
[MESH]
|Caloric Restriction
[MESH]
|Diet, Sodium-Restricted
[MESH]
|Humans
[MESH]
|Hyperaldosteronism/*etiology/metabolism/physiopathology/prevention & control
[MESH]
|Hypertension/*etiology/metabolism/physiopathology/prevention & control
[MESH]
|Mineralocorticoid Receptor Antagonists/therapeutic use
[MESH]
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