High blood pressure is a chronic disease in which the pressure of blood on the artery walls increases. High blood pressure puts a lot of pressure on the heart (increased burden on the heart) and is the cause of many serious cardiovascular complications such as: Stroke, heart failure, coronary heart disease, myocardial infarction, etc.
Among the many identified risk factors, obesity has emerged as one of the most important and common causes.
Is obesity really the leading cause of high blood pressure?
The harmful effects of obesity are as follows:
1. Burden on the entire cardiovascular system
Obesity is not simply a cosmetic problem. When body weight exceeds the normal level, especially when the BMI (Body Mass Index) is greater than 25, the entire body, including the cardiovascular system, is put in a state of overload. Excess weight forces the heart to work harder to pump blood to all tissues. This increases cardiac output, which means that blood pressure tends to increase over time.
Furthermore, fat cells (adipocytes) not only store energy but are also endocrine organs that produce a variety of hormones and inflammatory substances such as leptin, angiotensinogen, interleukin-6 (IL-6) and TNF-alpha. These substances can stimulate vasoconstriction, salt and water retention in the body, thereby leading to chronically high blood pressure.
2. Abdominal fat accumulation and its key role in hypertension
Not all types of fat have the same impact on blood pressure. Visceral fat, especially fat accumulated around the abdomen, is closely related to hypertension. Waist circumference above the threshold (≥90 cm for men and ≥80 cm for women in Asians) has been shown to be strongly associated with higher blood pressure.
The reason is that visceral fat is biologically active, secreting many inflammatory mediators and stimulating the sympathetic nervous system, causing vasoconstriction and water retention. At the same time, it reduces insulin sensitivity, creating insulin resistance – a factor directly related to hypertension.
3. Complex pathogenesis from obesity to hypertension
A series of pathogenesis mechanisms have been identified to explain why obesity is the leading caue of hypertension:
- Sympathetic nervous system stimulation: As body fat mass increases, leptin (a hormone secreted by adipose tissue) levels also increase. Leptin stimulates the sympathetic nervous system, increasing heart rate and vasoconstriction, thereby leading to increased blood pressure.
- Activation of the renin-angiotensin-aldosterone system (RAA): This is an important blood pressure regulation system that is often activated in obese people. When the RAA system is overactive, it causes salt and water retention, increases blood volume and increases blood pressure.
- Insulin resistance: Obesity causes insulin resistance, which prevents glucose from being absorbed effectively. This leads to metabolic disorders and damages the vascular endothelium, causing an imbalance between vasoconstrictor factors, increasing blood pressure.
- Chronic inflammation: Obesity is accompanied by mild but persistent inflammation, causing vascular endothelium to be damaged and lose its ability to regulate blood pressure.
4. Obesity is associated with many other risk factors
It is worth noting that obesity rarely exists alone. It is often accompanied by other risk factors such as: Type 2 diabetes, dyslipidemia, metabolic syndrome, sedentary lifestyle, high salt, fat and sugar diet
These factors not only independently cause high blood pressure but also combine to make the disease worse. Therefore, when treating high blood pressure in obese people, focusing only on medication is not enough, but it is necessary to combine comprehensive lifestyle changes.
In short, obesity is the leading cause of high blood pressure, but it is also an easy-to-control factor. Obesity is a silent enemy but can be controlled if we are persistent enough, understand correctly and act promptly. Its impact is not only in terms of weight but also entails many adverse biological changes that cause high blood pressure, prolonged and difficult to control. However, the good news is that obesity is a modifiable risk factor. If patients are aware and start changing their lifestyle, they can completely control their blood pressure, reduce the risk of cardiovascular disease and improve their quality of life.
