Obesity and Hypertension: Etiology and the Effects of Diet, Bariatric Surgery, and Antiobesity Drugs

Obesity-related hypertension (HTN) is a growing global health concern, being a significant contributor to cardiovascular morbidity and mortality. The article reviews the complex pathophysiological mechanisms involved in the link between obesity and HTN, including neurohormonal activation, inflammation, insulin resistance, and endothelial dysfunction. The role of adipokines, specifically leptin and adiponectin, in blood pressure regulation is highlighted, along with the impact of advanced glycation end-products on vascular function. We discuss the effectiveness of lifestyle therapies, including weight loss, and diet for the management of obesity HTN. We also discuss the utilization of pharmacologic agents, including GLP-1 receptor agonists, and the impact of bariatric surgery on long-term blood pressure control. Despite enhanced treatment, significant barriers to treatment exist, including obesity stigma, limited access to health care, and adherence problems. Future research must focus on personalized approaches, like pharmacogenomics, to optimize hypertension treatment in the obese.