Does being overweight cause hypertension?

2023-09-15 17:18:10

Reminder on hypertension:high blood pressure (hypertension) is characterized by abnormally high blood pressure exerted by the blood against the walls of the arteries, over a long period of time and not only during physical effort or in a stressful situation. In the long term, hypertension can be the cause of many cardiovascular illnessesvisual or kidney problems…

Although the origin of hypertension (hypertension) is not obvious, we know that certain factors make high blood pressure worse. Among them: tobacco, excessive salt consumption, alcohol, diabetes, stress… but also excess weight! Overweight? This is the term used by the World Health Organization (WHO) to describe “an abnormal or excessive accumulation of body fat that can be detrimental to health”. An adult (from the age of 20) is considered overweight whose body mass index (BMI) is between 25 and 29.9, and as obese if they have a BMI equal to or greater than 30. However, The BMI should however be considered as an approximate indication because it does not necessarily correspond to the same fat mass depending on the individual. Thus, it has been proven that blood pressure increases with BMI¹. Obese people are more at risk of developing hypertension than lean people; there are three times more high blood pressure in obese subjects than in non-obese subjects². In France, 17% of the population suffers from obesity and, among the health difficulties that can be linked, high blood pressure is the one with the highest prevalence. In France, 36% of obese people and 42% of massively obese people follow treatment for high blood pressure (while the national average is 30%).³. Studies estimate that 60 to 70% of the risk of high blood pressure is attributable to obesity⁴.

Hypertension and overweight, what are the links?

The reason for the association between increased body weight and an high blood pressure remains unclear¹. Several theses are put forward:

obesity is associated with higher levels of circulating insulin. Indeed, in the case of obesity, the triglycerides stored in adipose tissue – which are normally transformed into energy in the event of fasting or physical exercise for example – are present in too large quantities. They will then be deposited in peripheral organs and disrupt the action of insulin, increasing insulin resistance in overweight people (which helps by producing more glucose). This induces increased renal sodium retention, leading to increased blood pressure⁵.
Obesity predisposes the kidney to reabsorb more sodium via neural (SNS), hormonal (aldosterone and insulin) and renovascular mechanisms⁶. The kidney must therefore maintain higher blood pressure to excrete the daily salt intake.
When you are overweight or obese, the heart has to work harder to pump blood and this additional effort puts pressure on the arteries… which leads to an increase in blood pressure.
vascular resistance increases… and the work of the heart increases. To meet the body’s needs, the heart muscle (myocardium) must have increased activity and blood pressure increases.

Not to mention that being overweight increases cardiovascular risks, which further weakens the heart system.

Does losing weight lower blood pressure?

Weight loss, even minimal, can lower blood pressure¹. Several studies have in fact observed this, as evidenced by a meta-analysis involving moderately obese subjects, and with an average weight loss of less than 10 kilos, we observe, for each kilo lost, a reduction of 1 mmHg in blood pressure ( BP) systolic and 0.9 mmHg diastolic BP⁷. Weight loss, even modest (5% of weight), is always desirable in overweight or obese patients. Indeed losing weight allows :

reduce resistance to blood flow in the arteries, which helps lower blood pressure,
cause a reduction in the amount of fluid in the body, thus contributing to the reduction of blood pressure.
reduce the activity of the sympathetic nervous system, which is often associated with increased blood pressure.

What about physical activity? A physical activity associated with weight loss has a beneficial effect on blood pressure. But if physical activity is not coupled with weight loss, it has practically no effect on blood pressure.⁸. The reasons which could explain the link between sport and blood pressure? This could be due to the fact that physical exercise improves insulin sensitivityexplaining why exercise also reduces blood pressure¹.

The problem? Losing weight can be difficult to achieve, especially in the long term⁹. If the possibility of drugs that could lower blood pressure is being studied, for the moment, weight loss probably remains the best way to lower the pressure in the arteries when you suffer from obesity.

Fasting, obesity and high blood pressure

Lose weight when you are overweight or obese? It’s often complicated. However, the slightest weight loss is already very beneficial when you suffer from hypertension (hypertension)! Among the avenues that deserve to be studied is that of intermittent fasting.

The benefits of 16:8 fasting when you are overweight:

This diet may be easier to integrate because there is no deprivation and constraint; skipping a meal every day, rather than profoundly changing your diet by following a drastic diet, is, a priori, easier, and the risk of relapse is lower,
This helps reduce insulin resistance because not eating for at least 16 hours in a row allows you to have periods where insulin is very low,

A study¹⁰ was also carried out to observe the benefit of 16:8 fasting in overweight patients (by comparing their results to those of a control group). Published in the journal Nutrition and Healthy Agingresults showed that those who followed 16:8 intermittent fasting consumed an average of 350 fewer calories, lost 3% of their initial weight and had lower blood pressure than the control group.

^{1. Obesity : preventing and managing the global epidemic, Report of a World Health Organization Consultation.}

^{2. Van ltallie TB. Health implications of overweight and obesity in the United States. Annals of Internal Medicine, 1985, 103:983-988.}

^{3. Source: League against obesity.}

^{4. Kotchen TA. Obesity-related hypertension : Epidemiology, pathophysiology, and clinical management. Am J Hypertens 2010;23:1170-8.}

^{5. Brenner BM, Garcia DL, Anderson S. Glomeruli and blood pressure. Less of one, more the other ? American Journal of Hypertension, 1988, 1:335- 347.}

^{6. Landsberg L, Aronne LJ, Beilin LJ, et al. Obesity-related hypertension : Pathogenesis, cardiovascular risk, and treatment : A position paper of The Obesity Society and the American Society of Hypertension. J Clin Hypertens (Greenwich) 2013;15:14-33.}

^{7. Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure : A meta-analysis of randomized controlled trials. Hypertension 2003;42:878-84.}

^{8. Bouchonville M, Armamento-Villareal R, Shah K, et al. Weight loss, exercise or both and cardiometabolic risk factors in obese older adults : Results of a randomized controlled trial. Int J Obes (Lond) 2013 ; epub ahead of print.}

^{9. Treatment of arterial hypertension in obese subjects, Sophie Comte-Perret, Vittorio Giusti, Grégoire Wuerzner.}

^{10. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults : A pilot study.}

Does being overweight cause hypertension? – Advantages Magazine