New developments in the pathogenesis of obesity-induced hypertension

Vasilios Kotsis, Peter Nilsson, Guido Grassi, Giuseppe Mancia, Josep Redon, Frank Luft, Roland Schmieder, Stefan Engeli, Stella Stabouli, Christina Antza, Denes Pall, Markus Schlaich, Jens Jordan

Research output: Contribution to journalArticlepeer-review


Obesity is a disorder that develops from the interaction between genotype and environment involving social, behavioral, cultural, and physiological factors. Obesity increases the risk for type 2 diabetes mellitus, hypertension, cardiovascular disease, cancer, musculoskeletal disorders, chronic kidney and pulmonary disease. Although obesity is clearly associated with an increased prevalence of hypertension, many obese individuals may not develop hypertension. Protecting factors may exist and it is important to understand why obesity is not always related to hypertension. The aim of this review is to highlight the knowledge gap for the association between obesity, hypertension, and potential genetic and racial differences or environmental factors that may protect obese patients against the development of hypertension and other co-morbidities. Specific mutations in the leptin and the melaninocortin receptor genes in animal models of obesity without hypertension, the actions of α-melanocyte stimulating hormone, and SNS activity in obesity-related hypertension may promote recognition of protective and promoting factors for hypertension in obesity. Furthermore, gene-environment interactions may have the potential to modify gene expression and epigenetic mechanisms could also contribute to the heritability of obesity-induced hypertension. Finally, differences in nutrition, gut microbiota, exposure to sun light and exercise may play an important role in the presence or absence of hypertension in obesity.

Original languageEnglish
Pages (from-to)1499-1508
Number of pages10
JournalJournal of Hypertension
Issue number8
Publication statusPublished - Aug 11 2015


  • a-MSH
  • gut microbiota
  • hypertension
  • leptin
  • obesity
  • potassium
  • salt
  • sun light
  • sympathetic nervous system

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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