ReviewChoice of drug treatment for obesity-related hypertension: where is the evidence?Sharma, Arya M.a; Pischon, Tobiasa; Engeli, Stefana; Scholze, JuergenbAuthor Information aFranz-Volhard Klinik, Charité Campus-Buch and Max-Delbrück Centre for Molecular Medicine, and bCharité Campus-Mitte, Berlin, Germany. Received 22 September 2000 Revised 21 November 2000 Accepted 21 November 2000 Correspondence and requests for reprints to Professor Arya M. Sharma, Franz-Volhard Klinik am MDC, Charité Campus Buch, Wiltbergstr. 50, 13122 Berlin, Federal Republic of Germany. Tel: +49 30 9417 2203; fax: +49 30 9417 2206; e-mail: [email protected] Journal of Hypertension: April 2001 - Volume 19 - Issue 4 - p 667-674 Buy Abstract Hypertension and obesity are common medical conditions independently associated with increased cardiovascular risk. Many large epidemiological studies have demonstrated associations between body mass index and blood pressure, and there is evidence to suggest that obesity is a causal factor in the development of hypertension in obese individuals. Consequently, all hypertension management guidelines consider weight reduction as a first step in the management of increased blood pressure in obese individuals. Weight reduction may be achieved by behaviour modification, diet and exercise, or by the use of anti-obesity medications. However, the long-term outcomes of weight management programmes for obesity are generally poor, and most hypertensive patients will require antihypertensive drug treatment. Some classes of antihypertensive agents may have potentially unwanted effects on some of the metabolic and haemodynamic abnormalities that link obesity and hypertension, yet most hypertension guidelines fail to provide specific advice on the pharmacological management of obese patients. This may be because there are currently no studies examining the efficacy of specific antihypertensive agents in reducing mortality in obese hypertensive patients. This paper reviews the theoretical reasons for the differential use of the major classes of antihypertensive agents in the pharmacological management of obesity-related hypertension and also considers the potential role of anti-obesity agents. © 2001 Lippincott Williams & Wilkins, Inc.