The Role of Aldosterone in Obesity-Related Hypertension.

Abstract

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.

• Authors: Wakako Kawarazaki, Toshiro Fujita
• Journal: American journal of hypertension (Am J Hypertens) Vol. 29 Issue 4 Pg. 415-23 (Apr 2016) ISSN: 1941-7225 [Electronic] United States
• PMID: 26927805 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Mineralocorticoid Receptor Antagonists
• Receptors, Mineralocorticoid
• Sodium, Dietary
• Aldosterone

Topics

• Aldosterone (metabolism)
• Animals
• Blood Pressure
• Caloric Restriction
• Diet, Sodium-Restricted
• Humans
• Hyperaldosteronism (etiology, metabolism, physiopathology, prevention & control)
• Hypertension (etiology, metabolism, physiopathology, prevention & control)
• Mineralocorticoid Receptor Antagonists (therapeutic use)
• Obesity (complications, metabolism, physiopathology, therapy)
• Receptors, Mineralocorticoid (metabolism)
• Renin-Angiotensin System
• Risk Factors
• Risk Reduction Behavior
• Signal Transduction
• Sodium, Dietary (adverse effects)
• Sympathetic Nervous System (metabolism, physiopathology)