Relationship Between Obesity And Hypertension

 Obesity is when there is an increased amount of fat in the body which causes the BMI to increase and enter the ‘obese category’. Obesity causes high blood pressure which often results in resistant or primary hypertension as it also strains the cardiovascular system, in spite of the use of blood pressure medication. In a number of different ways, obesity may either initiate or exacerbate the development of hypertension. Because obesity is associated with a number of other health concerns, it may also make it more challenging to manage hypertension.

Causes of Hypertension with Obesity

If you already have hypertension, being obese might make it much more difficult to control your blood pressure. Having a greater amount of fat tissue in the body may result in a number of complicated changes, all of which can contribute to the development of hypertension or make the condition worse. These include the following:

• Excessive activation of the sympathetic nervous system which increases heart rate
• Excessive stimulation of the renin-angiotensin-aldosterone system (RAAS)
• alterations in the system of cytokines generated from adipose tissue (hormones)
• The kidneys and their functionality due to increased pressure

The increased pressure on the organs causes an excess amount of strain which is what links obesity and hypertension together. Obesity can end up causing several long term health issues such as cardiovascular diseases, diabetes, nerve damage, hypertension etc. Following are the causes:

1. Obesity - Induced Hypertension

Obesity is a chronic health condition that can cause or worsen hypertension in several ways. People that are obese tend to have a higher amount of visceral fat in their bodies. Obesity changes the way hormones send signals to the brain and hypertension can be caused due to the changed signaling patterns. Our nervous system is in charge of the fight or flight response that goes to our brain and obesity changes the basic functioning of the sympathetic nervous system causing hypertension. It also puts pressure to the abdominal organs and kidneys and alters their functioning, structure and efficiency.

2. Renin - angiotensin - aldosterone system

The RAAS system is considered to be a factor in the development of hypertension (high blood pressure). The function of the renin-angiotensin-aldosterone system is to regulate the blood pressure and volume across the entire body. It is possible for high blood pressure to persist for an extended period of time when the RAAS system is not functioning as it should. The levels of all of the hormones regulated by the RAAS increase when someone is obese. The result of this imbalance is elevated blood pressure also known as hypertension.

3. Sympathetic nervous system

The sympathetic nervous system is a component of the autonomic nervous system found inside the human body. The system is often referred to as the "fight-or-flight" system. Your metabolism and the condition of your heart are both directly impacted by its function. Having a significant amount of fat, particularly visceral fat, produces increased levels of the secretion of specific hormones. Because of these hormones, this system becomes hyperactive, which may ultimately lead to insulin resistance and even harm to the organs.

4. Renal compression

An excess amount of body fat causes a lot of strain on all the organs in the body. With an excess of abdominal fat, the kidneys are directly strained, which is normally the case with people with obesity. The kidneys are responsible for eliminating excess water from the body and controlling the amount of salt that is produced, both of which contribute to maintaining a healthy blood pressure. When under pressure for an extended period of time, your kidneys will become less effective at absorbing salt and water and will produce more urine as a result. In order for kidneys to work effectively, people who are obese need a more than usual amount of blood flow. In order to achieve this, the excess strain is what causes high blood pressure.

5. Leptin resistance

Leptin is a hormone that gives your brain the signal to stop eating by indicating it is full. This prevents overeating, helps to diminish appetite and helps to maintain your body weight. People who have obesity are usually resistant to the effects of leptin. They have an abundance of leptin in their bodies, but since their bodies are unable to utilize it in the appropriate manner, they do not get a feeling of fulfillment after meals. Those who are resistant to leptin are more likely to consume a larger amount of food while continuing to feel hungry, which may lead to an increase in body fat. The fact that more fat cells produce more leptin contributes to the issue, since it causes your body to develop an increased tolerance to the hormone's effects. The more amount of leptin is present in a person’s body, the more likely it is that they’ll become obese and subsequently develop hypertension.

6. Insulin resistance

It is a well known fact that people with obesity have a larger chance of developing additional illnesses such as type 2 diabetes, prediabetes, heart diseases, nerve and kidney damage. In fact, obesity is a direct cause of pre diabetes and type 2 diabetes as obesity causes insulin resistance. 

Insulin is a hormone that is produced by your pancreas. Insulin enables your cells to take in sugar and utilize it as a source of energy. Insulin resistance is a condition in which the cells in your body do not react to insulin in the usual manner. To get the same effect with insulin, more insulin is required. If you have type 2 diabetes, for example, your pancreas will eventually get overworked to the point where it will be unable to produce enough insulin to control your blood sugar levels. Having high blood sugar for an extended period of time has been known to cause damage to the arteries and make them hard. This is responsible for the worsening of hypertension and even causing it. ‍

Treatment  Hypertension in People with Obesity

There are various chronic health conditions such as diabetes and heart disease which do not have any set cures. However, that is not the case with obesity and hypertension as these are diseases that can be reversed with the right amount of treatment, lifestyle changes and time. It is completely possible to regulate your weight and blood pressure, as well as reverse or at least slow down these changes in your body. 

Losing weight is the key strategy used by medical professionals in the treatment of both obesity and hypertension. Doctors most often recommend making certain crucial changes to the routine and eating habits of people facing these challenges, and are occasionally (depending on the severity of the case) recommend bariatric or other types of weight reduction surgeries. In most cases, weight reduction (with or without surgical intervention) is combined with additional therapies, including the use of medication. In order to successfully control your weight with medication, your doctor will likely urge you to make significant adjustments to your lifestyle and make regular visits to the doctor in order to keep a check on the progress. 

Following are the treatment options you can follow to treat hypertension with obesity:

1. Dietary changes

One of the widely and commonly suggested treatment types to people with obesity and hypertension is making some dietary changes to the food they presently consume. The food we eat has a direct impact on the way our bodies function and it is crucial to eat a balanced and healthy diet every day. 

People with obesity and hypertension are advised to eat a healthy and balanced diet which includes exercising portion control. They should eat a low calorie or a calorie deficit diet with enough protein, fiber, healthy fats and less carbs. For example, people have varying caloric needs depending on their activity and metabolic levels and people with hypertension and obesity should consume somewhere between 500-1500 calories per day. Additional dietary changes include: 

• Eating less processed or packaged foods.
• Eating less foods that have a lot of salt in them
• Avoiding foods that have saturated fats and high levels of cholesterol
• Avoid consuming fried foods and foods that have a high sugar/carb level even if they are prepared at home. 
• Eating more home cooked meals
• Increasing their intake of fruits, vegetables, lean meats, eggs, fish and whole grains
• Drinking a lot of water throughout the day

2. Medications

The first course of action that is taken by any doctor upon the diagnosis of hypertension or high blood pressure is prescribing medication. Hypertension that is caused by obesity may be treated with a number of different drugs, which are normally prescribed by a doctor. The prescriptions may be more effective when taken together, or the doctor may choose to use a different medication if one of the others is ineffective. There are nine main kinds of antihypertensive drugs, each of which works in a different manner to lower blood pressure in the body. On an individual basis, physicians could also take into consideration the possibility of prescribing weight reduction medicines. There are some medicines for hypertension that work better when taken with medication for obesity and vice versa. 

Obesity and hypertension are closely linked and that is why it is important to treat these two conditions together.

3. Lifestyle changes

Something that is commonly heard while visiting doctors is the term ‘lifestyle changes’. But what does it really mean? The way we live our lives includes our routine, when we sleep, the food we eat, the things we do on a daily basis. Our level of activity throughout the day is also a significant factor when it comes to the kind of lifestyle we have. All of these things make a huge impact on our day to day and long term health. 

Whenever we are diagnosed with some illness or even have the common cold, we are advised to make certain changes to our daily routine in order to improve our health. Making these small but significant changes to our lifestyle will go a long way in maintaining and improving our health. Making these lifestyle changes will also help in shedding those extra kilos, achieving and maintaining a healthy body weight and keeping it off for a long time. It is the best way to combat obesity and hypertension in the long run. When it comes to losing weight for obesity and hypertension, the goal is to reduce the fat mass while preserving the amount of lean mass in the body. Here are the lifestyle changes that will help achieve your goals:

• Eating a diet that is nutritious, lower in calories, and limits caffeine intake is extremely important. It is the best way of resetting your health and body.
• Becoming active by finding something you love doing and doing it on a consistent basis. It could be anything, from a sport to a hobby, as long as it keeps your body active and moving.
• Having a good night's sleep is one of the best ways to give your body the time to heal and repair. Having a set sleep cycle is extremely important in combating hypertension and obesity.
• Quit smoking and drink or at least avoid it as much as possible. These directly harm your liver and can make hypertension worse. 
• One of the main concerns that comes with hypertension is handling stress. Mental wellbeing is a very important component of good health and preventing hypertension and activities that help you manage your stress levels like exercise, yoga and meditation are necessary. 
• Being diligent with your health includes checking your blood pressure and taking your medication daily. Monitor your blood pressure at home for the best results. 

Getting the support of your loved ones is very important in dealing with any kind of illness or lifestyle change. Talking to your friends and family is the best way to deal with it.

4. Surgery

Counseling on how to make positive adjustments to one's lifestyle is often offered by medical professionals who treat obesity. They will recommend a diet that reduces the amount of salt, caffeine, and alcohol consumed. They will also motivate people to exercise more often.

However, putting these changes into effect and maintaining them for a long period of time may be challenging. Alternatively, your doctor may recommend a rapid and significant weight loss programme in order to reduce the likelihood that you may have major consequences from your illness. If this is the case, your physician may also suggest bariatric surgery. To assist you in achieving your weight reduction goals, bariatric surgery, which includes procedures such as gastric bypass and other weight-loss treatments, involves making modifications to your digestive system. When diet and exercise have not been successful in helping a person lose weight, or when the person's weight is causing major health concerns, bariatric surgery may be an option. Surgery is recommended for the treatment of obesity-associated hypertension particularly if the patient has another ailment linked to obesity or a body mass index (BMI) of above 40. After the surgery,  patients saw a total disappearance of their previously diagnosed high blood pressure. After surgery, a greater number of people were able to decrease the amount of blood pressure medicine they needed to take. There are 4 main types of surgery procedures:

• gastric bypass 
• surgery with biliopancreatic diversion and duodenal switch
• adjustable gastric banding 
• sleeve gastrectomy

These treatments will all make your stomach smaller, which will restrict the amount of food that you can consume at one time. Gastric bypass and biliopancreatic diversion with duodenal switch also bypass some portions of the intestine which prohibits people from absorbing everything that they have consumed. ‍

Bottomline

Obesity and hypertension are among two of the most commonly experienced and rapidly rising diseases all over the world. More often than not they are linked and obesity can cause and worsen hypertension in various ways which may subsequently develop into other health conditions. These are normally treated together for best results. Both of these conditions can be managed and reversed with medication, lifestyle changes, exercise and making changes to one’s diet. Maintaining a healthy BMI is crucial to manage these conditions and is usually the first course of treatment. Surgery is also among its treatment options but is only recommended in extreme cases. Consistent checkups and regular visits to the doctor are extremely important as well as taking charge of your own life in order to get better. 

FAQs

Does obesity raise blood pressure?

Yes, obesity is the leading cause of increased blood pressure all over the world. Obesity is essentially an increase in weight which leads to an excess amount of added strain to all the organs and arteries. This is what causes high blood pressure or hypertension as the body has to work harder in order to transport blood everywhere effectively. 

Can hypertension be reversed by losing weight?

Yes, hypertension can be reversed by losing weight as this is a condition that is mainly caused due to being overweight or obese. Hypertension is caused by an increased blood pressure in the body due to being obese and losing even a small amount of weight can help in showing the changes in blood pressure.

What exercises should be avoided with high blood pressure?

If you have hypertension, you should avoid engaging in any kind of physical activity that demands abrupt bursts of activity or strain since these activities may raise the risk of arterial rupture, which may lead to a heart attack or stroke. Weight lifting, playing squash, and running are three examples of activities that should be avoided, along with skydiving and SCUBA diving, high intensity interval training, and swimming.‍

Can high blood pressure be cured by exercise?

Yes, high blood pressure can be cured by regularly exercising. Regular exercise leads to weight loss which is the key component in managing hypertension. Aim for at least 30 minutes of moderate exercises and avoid lifting weight and High intensity interval training for best results. Opt for activities like yoga, brisk walking and remaining active throughout the day.