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Background Obesity is an established risk factor for hypertension. Although obesity‐induced gut barrier breach leads to the leakage of various microbiota‐derived products into host circulation and distal organs, the roles of microbiota in mediating the development of obesity‐associated adrenomedullary disorders and hypertension have not been elucidated. We seek to explore the impacts of microbial DNA enrichment on inducing obesity‐related adrenomedullary abnormalities and hypertension. Methods and Results Obesity was accompanied by remarkable bacterial DNA accumulation and elevated inflammation in the adrenal glands. Gut microbial DNA containing extracellular vesicles (mEVs) were readily leaked into the bloodstream and infiltrated into the adrenal glands in obese mice, causing microbial DNA enrichment. In lean wild‐type mice, adrenal macrophages expressed CRIg (complement receptor of the immunoglobulin superfamily) that efficiently blocks the infiltration of gut mEVs. In contrast, the adrenal CRIg+ cell population was greatly decreased in obese mice. In lean CRIg −/− or C3 −/− (complement component 3) mice intravenously injected with gut mEVs, adrenal microbial DNA accumulation elevated adrenal inflammation and norepinephrine secretion, concomitant with hypertension. In addition, microbial DNA promoted inflammatory responses and norepinephrine production in rat pheochromocytoma PC12 cells treated with gut mEVs. Depletion of microbial DNA cargo markedly blunted the effects of gut mEVs. We also validated that activation of cGAS (cyclic GMP‐AMP synthase)/STING (cyclic GMP–AMP receptor stimulator of interferon genes) signaling is required for the ability of microbial DNA to trigger adrenomedullary dysfunctions in both in vivo and in vitro experiments. Restoring CRIg+ cells in obese mice decreased microbial DNA abundance, inflammation, and hypertension. Conclusions The leakage of gut mEVs leads to adrenal enrichment of microbial DNA that are pathogenic to induce obesity‐associated adrenomedullary abnormalities and hypertension. Recovering the CRIg+ macrophage population attenuates obesity‐induced adrenomedullary disorders.

Introduction: The prevalence of obesity is increasing in sub-Saharan Africa which reflects the current global trend. Epidemiological data have consistently shown a strong relationship between obesity and hypertension in Africans, and this association is stronger for central obesity. The aim of this study was to describe the pattern of overweight/obesity among patients living with hypertension in a tertiary hospital in Enugu, Southeast Nigeria. Methods: This was a cross-sectional study conducted in the Medical Out-Patient Clinic of the Enugu State University Teaching Hospital in Enugu, Enugu State, Southeast Nigeria. Data were analyzed using the SPSS version 22. Results: Data were collected from a total of 450 consenting patients, most of whom 64% (288) were females. The mean body mass index (BMI) was 28.9 ± 6.1 kg/m2 higher in females than males (29.8 ± 6.5 kg/m2 vs. 26.7 ± 5.2 kg/m2, P < 0.001). The gender distribution of classes of obesity showed female preponderance. A little more than one-third of the patients were overweight, whereas about four out of every ten patients were obese. While overweight did not differ significantly across gendeWr (P = 0.67), more feWmales than males were significantly obese (P < 0.001). The age distribution of BMI showed increasing rates of underweight and decreasing rate of morbid obesity with age. About 86.8% of the females had substantially increased waist circumference compared to 26.5% of the males. Overall, 53% of the males and 97.6% of the females have abnormal waist circumferences. Waist–hip ratio was equally abnormal in 89.3% of the study population even though no statistically significant difference was observed across gender. Conclusion: Overweight and obesity are common among patients with hypertension as demonstrated in this study. There is need to set up an aspect of health education which specifically sensitizes the public against the untoward consequences of overweight and obesity.

Two years after the publication of the 2013 guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC),1 the ESH and the European Union Geriatric Medicine Society have created a common working group to examine the management of hypertensive subjects aged >80 years. The general term hypertension in the elderly is not sufficiently accurate because it mixes younger old patients (60–70 years) with the oldest old. Our group believes that the management of hypertension in individuals aged ≥80 years should be specifically addressed. Although arbitrary, this cutoff value identifies a population that is expanding faster than any other age group with a 50% increase of life expectancy during the past 50 years2,3; furthermore, the incidence and prevalence of comorbidities, frailty, and loss of autonomy greatly increases after the age of 80 years4; finally, although there is limited evidence on the management of hypertension in this age group, the latest clinical studies indicate that in these patients, treatment may not be the same as in patients in the lower age strata. The aim of this Working Group was to discuss more in-depth treatment aspects of hypertensive patients aged ≥80 years or older, with special focus on the difficulties and uncertainties posed by very old frail individuals. We focused, in particular, on the following points of the 2013 ESH/ESC guidelines: The 2013 ESH/ESC guidelines1 reported the results of the Hypertension in the Very Elderly Double Blind Trial (HYVET). This showed that in hypertensive patients aged ≥80 years, the administration of the thiazide-like diuretic indapamide supplemented, if necessary, by the angiotensin-converting enzyme inhibitor perindopril led to a significant reduction in the …

Objectives:The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults.Method:Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex.Results:In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P

Objectives:The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults.Method:Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex.Results:In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P

Leptin je hormon adipoznog tkiva koji svoje efekte ostvaruje delovanjem na centralni nervni sistem. Leptin se vezuje za svoje OB receptore na neuronima hipotalamusa i posledično suprimira unos hrane i povećava aktivnost simpatičkog nervnog sistema čime stimuliše proces termogeneze i potrošnje energije. Osim što suprimira apetit i stimuliše termogenu potrošnju energije, leptin ostvaruje svoje efekte i na druge organske sisteme, kao što su endokrini, vaskularni, hematopoetski, imunski i mišićnoskeletni, delujući bilo direktno na periferiji organizma, bilo posredstvom centralnog nervnog sistema. Svoje efekte leptin ostvaruje putem veoma rasprostranjene mreže leptinskih receptora, preko nekoliko različitih molekularnih signalnih puteva. Stanje gojaznosti je praćeno povećanjem nivoa leptina u cirkulaciji usled povećane količine masnog tkiva, ali i pored toga, gojazne osobe ispoljavaju rezistenciju na anoreksigenične i metaboličke efekte leptina. Izvestan broj studija je pokazao da leptin može povećati aktivnost simpatičkog nervnog sistema i u netermogenim tkivima glodara dovodeći do hipertenzije usled gojaznosti. Koncept selektivne rezistenicije na leptin predstavlja moguće objašnjenje ovog paradoksa. Još uvek su malobrojne studije u kojima je ispitivan fenomen selektivne leptinske rezistencije kod ljudi. U okviru ovog preglednog članka, dat je prikaz najnovijih saznanja o leptinu, mehanizmu njegovog delovanja kao i o ulozi leptina u patofiziološkim stanjima. Leptin is a hormone produced by the adipose tissue, which has effects on the central nervous system. Leptin is bound to its Ob receptor on hypo-thalamic neurons to inhibit feeding behavior and to increase sympathetically-mediated thermogenesis. In addition to anorexia and thermogenesis, leptin also has direct peripheral and central nervous system-mediated effects on the endocrine, vascular, hematopoietc, immune and musculoskeletal systems. Leptin accomplishes its effects using distributed network of leptin receptors and differential molecular signaling pathways. Leptinemia is increased in obesity because of increased adipocyte mass, but obese subjects exhibit resistance to the anorexic and metabolic effects of leptin. However, multiple studies have shown that leptin can increase sympathetic nerve activity to non-thermogenic tissues in rodents causing obesity-related hypertension. One potential explanation of this paradox is selective leptin resistance. Compared with large and persuasive number of studies on the sympathetic and blood pressure effects of leptin in experimental animals, relatively little attention was given to these effects of leptin in humans. This review article presents recent findings related to leptin and its mechanism of action, and also the role of leptin in patophysiological conditions.

Objectives: The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults. Method: Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex. Results: In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P