Obesity

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Strong evidence has been developed that autonomic control importantly and often crucially determines sodium and water homeostasis, and this autonomic control may have an important link with the hypertension of obesity. Ganglionic blockade with the combined analysis of blood pressure fall and changes in blood pressure variability is a unique utility to dissect autonomic mechanisms of hypertension. As an example, the majority of obese patients have high blood pressure that can be reduced to normal values by ganglionic blockade. Moreover, the initial power of low frequency oscillation is higher in obese patients than in healthy subjects. This indicates that hypertension in obese patients is mainly caused through neurogenic pathways.

Autonomic Blockade Hypertension
Fig. 2. Final intrinsic systolic blood pressure (SBP) produced by intravenous infusion of trimethaphan in patients with pure autonomic failure (PAF), multiple system atrophy (MSA), essential hypertension (HTN), and normal subjects (NORM).
Hypertension Range
Fig. 3. Resting systolic blood pressure (SBP) variability in the low frequency range (LFSBP) in patients with pure autonomic failure (PAF), multiple system atrophy (MSA), essential hypertension (HTN), and normal subjects (NORM).

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