Hyperleptinemia as a risk factor in obesity-related hypertension

BACKGROUND AND OJBECTIVE: Obesity is a risk factor for high blood pressure (HBP). However, the mechanism has not been dilucidated yet. High concentrations of leptin (LEP) contributing to an increased blood pressure in obese patients via increase in the activity of the sympathetic nervous system. We explored the physiopathologic role of hyperleptinemia in HBP with regard to obesity. SUBJECTS AND METHOD: Prospective and comparative study. Between February 2001 and December 2002, we studied 499 subjects, 255 with HBP and 244 without hypertension. The relationship between weight, LEP, insulin, and serum lipids with blood pressure was assessed. RESULTS: Patients with HBP versus patients without HBP had a higher body mass index (30.4 +/- 3.9 to 25.5 +/- 1.7 kg/m(2)) (p < 0.01), higher serum concentrations of: creatinine (0.99 +/- 0.16 to 0.88 +/- 0.16 mg/dl), total cholesterol (219.5 +/- 50.4 to 190.6 +/- 40.0 mg/dl), cLDL (126.9 +/- 52.2 to 108.3 +/- 53.3 mg/dl), triglycerides (221.1 +/- 123.8 to 164.5 +/- 86.5 mg/dl), LEP (14.9 +/- 8.4 to 6.7 +/- 3.5 ng/ml) and insulin (24.2 +/- 6.5 to 16.8 +/- 4.7 mU/ml) (p < 0.01). In the univariate and multivariate analysis, obesity, dyslipidemia, hyperleptinemia and hyperinsulinemia were independent risk factors for HBP (p < 0.01). CONCLUSIONS: We suggest that hyperleptinemia has a direct role in the physiopathologic mechanism of obesity-associated HBP, and it could be considered as an independent risk factor for HBP and cardiovascular disease.