How Obesity Affects Your Blood Pressure (And What You Can Do About It)
Medically reviewed by Jeffrey S. Lander, MDMedically reviewed by Jeffrey S. Lander, MD
Obesity is a medical condition that can present a range of health complications, including high blood pressure (hypertension). Excess weight increases the heart's workload, straining the heart and leading to problems like high blood pressure.
A higher body mass index (BMI) is becoming more common, and severe obesity—defined as a BMI of 40 or greater—has more than doubled over the past 20 years. More than 40% of American adults struggle with obesity, and an additional 10% have severe obesity.
This article will explore the link between obesity and hypertension and what you can do to limit your risks.
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BMI and Your Health
BMI is a calculation of your weight divided by your height. A high BMI could indicate a high level of body fat. However, BMI is not an exact measurement tool. According to the Centers for Disease Control and Prevention (CDC), healthcare providers should not use BMI to diagnose body fatness or overall health. There are many health metrics outside of BMI, and this calculation doesn't consider things like muscle mass or metabolism.
Understanding the Connection Between Weight and Blood Pressure
Your heart is the hardest-working muscle in your body. It pumps nearly 2,000 gallons of blood through your body every day. However, body size, cholesterol level, circulation, and other factors can make the heart's work more difficult.
Any obstruction or issue that interferes with blood flow increases the demand on your heart. Higher body fat levels have been directly linked to increased blood pressure for decades. There are several reasons for this. A higher body weight can make it harder for your heart to pump blood. Increased cholesterol and fatty deposits in your blood vessels make your heart push blood through with more force, causing high blood pressure. Today, obesity is linked to between 65% and 78% of primary hypertension cases.
Can Obesity Cause Hypertension?
Experts know that there is a relationship between obesity and hypertension. However, there are several ways that obesity can lead to hypertension.
One study that followed a group of obese women for 14 years revealed that BMI was the most substantial risk factor for developing hypertension and that women with obesity (a BMI of ≥30) were five times more likely to have high blood pressure than women with a BMI of 23 and lower.
Obesity vs. Overweight
"Overweight" and "obese" are often used interchangeably, but these terms signal different levels of excess weight. BMI is imperfect, but it's the most efficient tool healthcare providers can use to gauge weight and excessive body fat.
According to the World Health Organization (WHO):
A BMI over 25 is overweight
A BMI of over 30 is obese
This distinction is important because each level carries specific health risks.
What’s Obesity-Induced Hypertension?
Obesity-induced hypertension is high blood pressure linked to body mass and related complications. The sections below discuss some of the physiological issues that contribute to obesity-induced hypertension.
Sympathetic Nervous System
Your sympathetic nervous system (SNS) controls your body's response to stress or physical challenges. It activates your flight-or-fight response when danger is perceived. In people with obesity, SNS activity is increased. An overactive SNS can increase heart rate and cardiac output—the amount of blood your heart can pump in a minute. Increased cardiac output can put a strain on your heart.
Studies show that even moderate weight gain can increase SNS activity, though it measures highest in people with both obesity and hypertension.
Renin-Angiotensin-Aldosterone System
The renin-angiotensin-aldosterone system (RAAS) is a hormone system responsible for regulating blood pressure, fluids and electrolytes, and vascular resistance (the force the vascular system exerts on circulating blood). SNS stimulation increases the production and release of hormones in this system, contributing to increased blood pressure.
Renal Compression
Increased fatty tissue—especially around the abdomen—can make space inside the body tight. As space shrinks and pressure increases, people with obesity can experience compression of various organs, including the kidneys, which are part of the renal system. Compressed kidneys cause increased pressure in the renal arteries.
Leptin Resistance
Leptin is a molecule that is produced by fat cells, and its job is to help regulate food intake and energy. It can also increase SNS activity and narrow your blood vessels to increase blood pressure.
When your leptin levels are chronically high, your body resists it. When this happens, the body is unable to tell when you're full, which can contribute to obesity.
Insulin Resistance
As with leptin, chronically high blood glucose levels lead to increased production of insulin. When your body becomes too used to high amounts of insulin, you can develop a resistance to that as well.
Insulin resistance is common in people with obesity, and it can make hypertension worse due to its triggering effects on the SNS and RAAS systems. Insulin can open blood vessels to help decrease blood pressure, so people with insulin resistance have their blood vessels constantly constricted. This can worsen high blood pressure. Insulin resistance can also make it more difficult to lose weight—which is one of the primary methods for treating high blood pressure.
Learn More: Does Sugar Raise Blood Pressure?
How Is Hypertension Treated in People With Obesity?
Regardless of your body size, weight, BMI, gender, age, or race, lifestyle changes are the first recommendation your healthcare provider will make to reduce your blood pressure.
In early stages of hypertension, lifestyle changes may be enough to lower your blood pressure to safe levels. If your hypertension is more advanced or lifestyle changes haven't worked for you, your healthcare provider might add one or more medications.
Lifestyle Changes
Getting regular exercise is one of the first things you can do to help get your blood pressure down to a healthy range. If you aren't already active, start slowly. Even something as simple as taking a walk each day can make a difference.
Physical activity offers many benefits. It can help lower your blood pressure, lose weight, and improve other aspects of your cardiovascular health.
Other lifestyle changes to consider that could benefit both your weight and blood pressure include things like:
Quitting smoking
Reducing your alcohol intake
Reducing stress
Decreasing caffeine intake
Learn More: Diet or Exercise: Which One Is Better for Managing Blood Pressure?
Dietary Changes
Dietary changes can help control your weight and your blood pressure. Decreasing your intake is one aspect of this, but it's also important to consider what kinds of foods you are eating.
A heart-healthy diet includes plenty of foods like:
Fresh fruits and vegetables
Whole grains
Low-fat dairy
Skinless chicken and fish
Nuts and beans
Certain vegetable oils and fats
It's important to incorporate these into your daily diet but also avoid things like:
Trans fats
Saturated fat
Sodium
Fatty or processed meats
Foods with added sugar or sweeteners
Can Weight Loss Cure Hypertension?
Losing just 10 pounds can be enough to help reverse some weight-related health problems, including high blood pressure, according to the American Heart Association. Weight gain is linked to a greater risk of high blood pressure, and one study found that women who gained 50 or more pounds were five times more likely to develop high blood pressure than women who maintained their weight.
Medications
Even with diet and lifestyle changes, you may need medications to help control your blood pressure. There are several different kinds of antihypertensive medications, and finding the right choice for you may take some time. Your healthcare provider will work with you to find the best treatment, which usually involves mixing one or more different types of blood pressure medications.
Read Next: Hypertension (High Blood Pressure) Treatment
Surgery
Surgery is not a top choice when it comes to managing high blood pressure. There are many risks to any type of surgery, and surgical techniques to reduce blood pressure don't work for everyone. One method is to destroy some of the nerves in your renal artery with the goal of decreasing the effects of the RAAS.
Other surgeries can help control hormone levels that contribute to high blood pressure, but because hypertension has several causes, a single surgery may not resolve it completely. Metabolic and other weight loss surgeries are also an option, but weight loss doesn't guarantee other problems will go away completely. Even with surgery, you may need to continue with lifestyle changes and medications.
Related: Being Overweight Doubles Your Chances of Having a Stroke
Hypertension in Children With Obesity
As with adults, childhood obesity is on the rise, and along with it comes an increase in pediatric hypertension. Roughly 20% of American children are considered obese, and 4% have hypertension that is linked to body mass.
Identifying and addressing obesity and hypertension in children is critical to preventing long-term organ damage and other chronic diseases. Management of obesity and hypertension is similar in both adults and children, and it's important that pediatricians be part of the plan.
Preventing Hypertension in People With Obesity
Maintaining a healthy diet and lifestyle can help you avoid developing high blood pressure, but if you are struggling with obesity, it might not be enough. You can have a higher BMI and still be fit and active, but research suggests that this still isn't enough to avoid many of the health complications related to weight.
If you are struggling with your weight or BMI, talk to your healthcare provider about what you can do to lose weight and improve your overall cardiovascular health.
Summary
Obesity is a known contributor to high blood pressure, among other health risks. Your weight can impact increased body fat, changes in metabolism and hormones, and other processes that help regulate your blood pressure.
If you are trying to manage your weight and/or blood pressure, talk to your healthcare team about the best way to manage each of these concerns. Weight loss can help reduce your blood pressure, but you may need to consider other treatments, as well.
Read the original article on Verywell Health.
