06/02/2025
Hypertension is a major risk factor for cardiovascular and renal disease in the UK and worldwide. Obesity contributes to much of the risk of primary hypertension through several mechanisms, including neurohormonal activation, inflammation, and renal dysfunction. As the prevalence of obesity continues to increase, so will hypertension and associated cardio-renal disease unless more effective obesity prevention and treatment strategies are developed. Lifestyle changes, including diet, reduction of sedentariness, and increased physical activity, are commonly recommended for people with obesity; however, these strategies have had limited long-term success in reducing fat, maintaining weight loss, and lowering blood pressure. Effective pharmacological and procedural strategies, including metabolic surgery, are additional options for treating obesity and preventing or mitigating obesity hypertension, target organ damage, and subsequent disease. Medications are available for short- and long-term obesity treatment, but prescriptions for these medications are limited. Metabolic surgery is effective for sustained weight loss, treatment of hypertension and metabolic disorders in many patients with severe obesity. Many questions remain unanswered about the pathogenesis of obesity-related diseases, the long-term efficacy of different treatment and prevention strategies, and the timing of these interventions to prevent obesity- and hypertension-mediated targets.
