Arterial hypertension in obese patients: clinical and pathogenetic features

Induced arterial hypertension (AH) is one of the forms of AH, the pathogenetic mechanisms of which are well studied: the main reason is the disruption of the functioning of visceral adipose tissue, which leads to activation of the renin-angiotensin-aldosterone system, imbalance of the sympathetic and parasympathetic systems, kidney damage, endothelial dysfunction of vessels and, in fact, to increased blood pressure (BP) and consolidation of AH. However, among this form of AH, additional mechanisms can be distinguished that play a special role in the formation of hypertension in obesity. This review describes such mechanisms as chronic inflammation, excessive salt intake, dysbiosis and environmental factors. Understanding these features of AH in obesity is of great importance for achieving target levels of AH. Special attention is paid to such forms of AH as masked and nocturnal hypertension, the timely diagnosis of which is critically important for effective treatment and improving prognosis.