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High Blood Pressure Treatment (cont.)

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Being overweight can increase the risk for high blood pressure. Obesity is common among hypertensive patients, and its prevalence, especially in aging patients, can contribute to hypertension in several ways. In obese people the heart has to pump more blood to supply the excess tissue. The increased cardiac output can then raise the blood pressure. In addition, obese hypertensive individuals have a greater stiffness (resistance) in their peripheral arteries throughout the body. Insulin resistance and the metabolic syndrome, which are associated with hypertension, also occur more frequently in the obese. Finally, obesity may be associated with a tendency for the kidneys to retain salt. Weight loss may help reverse obesity-related problems and may lower blood pressure. Losing as little as 10 to 20 pounds can help lower blood pressure and the risk of heart disease.

The American Journal of Clinical Nutrition reported in 2005 that waist size, a measure of central body obesity, was a better predictor of a person's blood pressure than body mass index (BMI), a measure of overall obesity. Men should strive for a waist size of 35 inches or under and women 33 inches or under.

Some very obese people have a syndrome called sleep apnea, which is characterized by periodic interruption of normal breathing during sleep. Sleep apnea may contribute to the development of hypertension in this subgroup of obese individuals. Repeated episodes of apnea cause a lack of oxygen (hypoxia), causing the adrenal gland to release adrenaline and related substances which cause a rise in the blood pressure.



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