Combined Renal Effects of Overweight and Hypertension

The existence of a direct relationship between body mass and arterial pressure is well recognized; however, the effect of obesity on known target organs of hypertension is not clearly understood. We undertook the present studies to assess the influence of obesity on renal function and urinary albumi...

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Veröffentlicht in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 1995-10, Vol.26 (4), p.610-615
Hauptverfasser: Ribstein, Jean, du Cailar, Guilhem, Mimran, Albert
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container_title Hypertension (Dallas, Tex. 1979)
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creator Ribstein, Jean
du Cailar, Guilhem
Mimran, Albert
description The existence of a direct relationship between body mass and arterial pressure is well recognized; however, the effect of obesity on known target organs of hypertension is not clearly understood. We undertook the present studies to assess the influence of obesity on renal function and urinary albumin excretion in 40 normotensive subjects and 80 never-treated hypertensive patients matched for age, sex, arterial pressure level, and known duration of hypertension in whom an oral glucose tolerance test was within normal limits. Glomerular filtration rate and effective renal plasma flow (expressed as absolute values or values normalized for height) were increased in overweight compared with lean subjects whether normotensive or hypertensive. Glomerular filtration rate was positively correlated with protein intake (as assessed from urinary excretion of urea) and fasting serum insulin level. Urinary excretion of albumin but not IgG and beta2 microglobulin was higher in hypertensive patients compared with normotensive subjects. The overweight condition clearly enhanced the influence of arterial pressure on albuminuria; in fact, a steeper regression line between albumin excretion rate and arterial pressure was found in overweight compared with lean subjects. These results indicate that the overweight condition is associated with renal hyperfiltration and hyperperfusion, irrespective of the presence of hypertension, and that obesity magnifies the effect of hypertension on albuminuria, thus raising the possibility of an increased susceptibility of obese hypertensive patients to the development of renal damage. (Hypertension. 1995;26:610-615.)
doi_str_mv 10.1161/01.hyp.26.4.610
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We undertook the present studies to assess the influence of obesity on renal function and urinary albumin excretion in 40 normotensive subjects and 80 never-treated hypertensive patients matched for age, sex, arterial pressure level, and known duration of hypertension in whom an oral glucose tolerance test was within normal limits. Glomerular filtration rate and effective renal plasma flow (expressed as absolute values or values normalized for height) were increased in overweight compared with lean subjects whether normotensive or hypertensive. Glomerular filtration rate was positively correlated with protein intake (as assessed from urinary excretion of urea) and fasting serum insulin level. Urinary excretion of albumin but not IgG and beta2 microglobulin was higher in hypertensive patients compared with normotensive subjects. The overweight condition clearly enhanced the influence of arterial pressure on albuminuria; in fact, a steeper regression line between albumin excretion rate and arterial pressure was found in overweight compared with lean subjects. These results indicate that the overweight condition is associated with renal hyperfiltration and hyperperfusion, irrespective of the presence of hypertension, and that obesity magnifies the effect of hypertension on albuminuria, thus raising the possibility of an increased susceptibility of obese hypertensive patients to the development of renal damage. 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The overweight condition clearly enhanced the influence of arterial pressure on albuminuria; in fact, a steeper regression line between albumin excretion rate and arterial pressure was found in overweight compared with lean subjects. These results indicate that the overweight condition is associated with renal hyperfiltration and hyperperfusion, irrespective of the presence of hypertension, and that obesity magnifies the effect of hypertension on albuminuria, thus raising the possibility of an increased susceptibility of obese hypertensive patients to the development of renal damage. (Hypertension. 1995;26:610-615.)</description><subject>Adolescent</subject><subject>Adult</subject><subject>Albuminuria - urine</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood - metabolism</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. 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Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood - metabolism</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - physiopathology</topic><topic>Kidney - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Obesity - complications</topic><topic>Obesity - physiopathology</topic><topic>Proteinuria - urine</topic><topic>Renal Circulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ribstein, Jean</creatorcontrib><creatorcontrib>du Cailar, Guilhem</creatorcontrib><creatorcontrib>Mimran, Albert</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ribstein, Jean</au><au>du Cailar, Guilhem</au><au>Mimran, Albert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combined Renal Effects of Overweight and Hypertension</atitle><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle><addtitle>Hypertension</addtitle><date>1995-10</date><risdate>1995</risdate><volume>26</volume><issue>4</issue><spage>610</spage><epage>615</epage><pages>610-615</pages><issn>0194-911X</issn><eissn>1524-4563</eissn><coden>HPRTDN</coden><abstract>The existence of a direct relationship between body mass and arterial pressure is well recognized; however, the effect of obesity on known target organs of hypertension is not clearly understood. 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The overweight condition clearly enhanced the influence of arterial pressure on albuminuria; in fact, a steeper regression line between albumin excretion rate and arterial pressure was found in overweight compared with lean subjects. These results indicate that the overweight condition is associated with renal hyperfiltration and hyperperfusion, irrespective of the presence of hypertension, and that obesity magnifies the effect of hypertension on albuminuria, thus raising the possibility of an increased susceptibility of obese hypertensive patients to the development of renal damage. (Hypertension. 1995;26:610-615.)</abstract><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>7558220</pmid><doi>10.1161/01.hyp.26.4.610</doi><tpages>6</tpages></addata></record>
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source MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete
subjects Adolescent
Adult
Albuminuria - urine
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood - metabolism
Blood and lymphatic vessels
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Female
Glomerular Filtration Rate
Humans
Hypertension - complications
Hypertension - physiopathology
Kidney - physiopathology
Male
Medical sciences
Middle Aged
Obesity - complications
Obesity - physiopathology
Proteinuria - urine
Renal Circulation
title Combined Renal Effects of Overweight and Hypertension
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