Table 5.

Mechanisms of obesity-related hypertension

Sympathetic nervous system activation

Renal mechanisms

• Shift of pressure natriuresis towards sodium and fluid retention

• Renal renin-angiotensin-aldosterone system activation

• Renal tissue compression by perirenal fat to induce hyperfiltration

Hormonal abnormalities

• Insulin resistance/hyperinsulinemia

• Hyperleptinemia

• Adipose tissue derived renin-angiotensin-aldosterone system activation

• Aberrant adipokines

Endothelial dysfunction

• Activation of proinflammatory pathways to induce atherosclerotic vascular wall changes

• Reduced vasodilatation due to nitric oxide inactivation and degradation

Note:

^*This table is a simplified list of mechanisms, and any of these factors are likely to interact to cause hypertension.