Abstract

The hypertension that occurs in association with obesity confers substantial cardiovascular risk and warrants an aggressive therapeutic approach. This should include lifestyle modifications that foster weight loss and enhance insulin sensitivity as a part of every therapeutic regimen. Although rarely sufficient in and of themselves, these lifestyle changes improve the response to antihypertensive medications and exert a beneficial effect on other aspects of the risk profile associated with obesity and hypertension.

Combinations of antihypertensive drugs should be employed to achieve blood pressure levels in the range of those recommended for patients with type 2 diabetes. Agents that improve the metabolic profile (rather than those associated with deterioration of that profile) should be considered as part of the antihypertensive drug combination.

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