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The combination of obesity and hypertension: a highly unfavorable phenotype requiring attention

Arena, Ross; Daugherty, John; Bond, Samantha; Lavie, Carl J.; Phillips, Shane; Borghi-Silva, Audrey

Current Opinion in Cardiology: July 2016 - Volume 31 - Issue 4 - p 394–401
doi: 10.1097/HCO.0000000000000294
HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie

Purpose of review Body habitus is a key lifestyle characteristic whose current status and future projections are disconcerting. The percentage of the global population who are either overweight or obese has substantially increased, with no indication that any country has a solution to this issue. Hypertension is a key unfavorable health metric that, like obesity, has disastrous health implications if left uncontrolled. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult to treat phenotypes. Excess body mass is such an example, creating an obesity–hypertension phenotype, which is the focus of this review.

Recent findings An increased risk for hypertension is clearly linked to obesity, indicating that the two conditions are intimately linked. The cascade of obesity-induced pathophysiologic adaptations creates a clear path to hypertension. Adopting a healthy lifestyle is a primary intervention for the prevention as well as treatment of the obesity–hypertension phenotype.

Summary The obesity–hypertension phenotype is highly prevalent and has disastrous health implications. A primordial prevention strategy, focused on lifelong healthy lifestyle patterns, is the optimal approach for this condition. For those individuals already afflicted by the obesity–hypertension phenotype, interventions must aggressively focus on weight loss and blood pressure control.

aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences

bDepartment of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, Illinois

cDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School—The University of Queensland School of Medicine; New Orleans, Louisiana, USA

dCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil

Correspondence to Ross Arena, PhD, PT, FAHA, Professor, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, 1919 W. Taylor Street (MC 898), Chicago, IL 60612. Tel: +312 355 3338; e-mail:

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.