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Dr. Pablo Dayer, St. Luke's Hospital

The link between obesity and high blood pressure

According to the most recent statistics available from the U.S. Department of Health and Human Services Office on Women's Health, Missouri ranks 44 out of the 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands for the prevalence of obesity in women. Illinois ranks 25.

It is no surprise that these states also rank poorly for the number of women diagnosed with high blood pressure. Missouri ranks 38. Illinois ranks 36.

High blood pressure is a major risk factor for heart disease, stroke, congestive heart failure and kidney disease. The cause of 90 percent of the cases of high blood pressure is not known; however, women with the highest rates of high blood pressure are more likely to be overweight or obese. Based on an analysis of data from the National Health and Nutrition Examination Survey (NHANES), high blood pressure has been recorded in 46 percent of obese women.

There are multiple reasons why obesity causes high blood pressure. One reason is it appears that the excess adipose, or fat, tissue secretes substances and hormones that are acted on by the kidneys, resulting in high blood pressure. Due to the excess adipose tissue, there are also generally higher amounts of the hormone insulin produced by the pancreas which also elevates blood pressure.

In addition, new research closely correlates body mass index (BMI) and aldosterone levels. Aldosterone is a hormone that increases the reabsorption of sodium and water by the kidneys. By doing this, aldosterone leads to sodium and fluid retention and, ultimately, the development of high blood pressure.

Understanding why obesity is linked to high blood pressure is important for its prevention and treatment. Lifestyle modifications including weight loss, a low sodium diet, increased physical activity and moderation in alcohol consumption may result in significant blood pressure improvement. Additionally, medications directed to block aldosterone may be a particularly effective treatment in overweight or obese women with high blood pressure that is difficult to control.

If you are overweight and have difficulty controlling your blood pressure, talk with a specialist in high blood pressure. New treatments may help.

Dr. Pablo Dayer is a board-certified nephrologist at St. Luke's Hospital. Call
314-205-6600 or visit his Meet the Doctor page.

This article was published in the St. Louis Post-Dispatch on June 30, 2011.