Managing big issues on lean evidence: treating obesity hypertension

Obesity, defined as a body mass index (BMI) greater than 30 kgum, is an important risk factor for hypertension, and excess adiposity is believed to account for 70% of hypertension in men and 60% in women w1,2x. There is now accumulating evidence that adipose tissue may itself be involved directly in the pathogenesis of hypertension, not only by contributing to an increase in sympathetic activity w3x, but also to sodium and volume retention w4x. Obesity—a risk factor neglected by current guidelines