Prakt. lékáren. 2016; 12(5): 176-181 | DOI: 10.36290/lek.2016.043

Safe and effective antihypertensive therapy in obesity

Iva Prokopová

Oddělení klinické farmacie, Ústavní lékárna IKEM, Praha

Prevalence of arterial hypertension, which is in most cases resistant to standard therapy, is on the increase due to the obesity

epidemic. Obesity is one of the main causes of hypertension, disrupting the efficacy of antihypertensive therapy. Obesity-related

hypertension is triggered by an increase of sympathomimetic activity, an impaired renin-angiotensin-aldosterone system, hyperinsulinemia

and hyperleptinemia. These pathophysiological alterations determine the appropriate choice of antihypertensive

agents used. According to pharmacokinetic changes in obese patients, higher doses of antihypertensives are now required. The

preferred agents are angiotensin-converting inhibitors or sartans. In multiple combinations, calcium channel blockers, small doses

of diuretics, imidazoline receptor agonists and alpha and beta-receptor antagonists are also used. Excessive weight reduction

and lifestyle modifications are essential parts of therapy.

Keywords: obesity, arterial hypertension, metabolic syndrom, antihypertensive drugs, pharmacokinetics

Published: October 1, 2016  Show citation