Treatment of arterial hypertension in obese subjects

Abstract

All over the world, the increasing incidence of obesity, which, particularly in the abdominal type, is associated with arterial hypertension. In the development of hypertension in obese persons, increased sympathetic activity and hyperinsulinemia play particular role. The gudelines for the treatment of arterial hypertension, based on the results of scientific investigations, were not prepared as yet. Numerous indirect evidences suggest that treatment of hypertension in obese persons should follow the same rules as in patients with type 2 diabetes mellitus. Besides body weight reduction and changes of the life style, the pharmacotherapy should be started immediately. The drugs of the first choice are most propably angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, diuretics in the small doses and nondihydropiridine calcium antagonists. In particular situations, the b-adrenolitics may be beneficial. Effective treatment requires most often use of several hipotensive drugs from different groups. Further studies on the treatment of arterial hypertension in obese persons are needed.