TY - JOUR
T1 - Sex differences in sympathetic activity in obesity and its related hypertension
AU - Fu, Qi
N1 - Funding Information:
This brief review article was supported, in part, by the National Institutes of Health R21 (HL088184), the American Heart Association Grant-in-Aid (13GRNT16990064), and the Harry S. Moss Heart Trust awards (2015-2019).
Publisher Copyright:
© 2019 New York Academy of Sciences.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - The prevalence of obesity is rapidly increasing in the United States, particularly among women. Approximately 60−70% of hypertension in adults may be directly attributed to obesity. In addition, maternal obesity is a major risk factor for hypertensive disorders during pregnancy. The underlying mechanisms for the association between obesity and cardiovascular risk are multifactorial, but activation of the sympathetic nervous system is one significant contributing factor. This brief review summarizes the current knowledge on sex differences in sympathetic activity in obesity and its related hypertension, with a focus on studies in humans. Evidence suggests that abdominal visceral fat, rather than subcutaneous fat, is related to augmented sympathetic activity regardless of sex. Race/ethnicity may affect the relationship between obesity and sympathetic activity. Obesity-related hypertension has an important neurogenic component, which is characterized by sympathetic overactivity. However, sex may influence the association between hypertension and sympathetic overactivity in obese people. Finally, both body weight and sympathetic overactivity seem to be involved in the development of gestational hypertensive disorders in women. Chronic hyperinsulinemia due to insulin resistance, high plasma levels of leptin, and/or obstructive sleep apnea may be responsible for sympathetic overactivity in obesity-related hypertension.
AB - The prevalence of obesity is rapidly increasing in the United States, particularly among women. Approximately 60−70% of hypertension in adults may be directly attributed to obesity. In addition, maternal obesity is a major risk factor for hypertensive disorders during pregnancy. The underlying mechanisms for the association between obesity and cardiovascular risk are multifactorial, but activation of the sympathetic nervous system is one significant contributing factor. This brief review summarizes the current knowledge on sex differences in sympathetic activity in obesity and its related hypertension, with a focus on studies in humans. Evidence suggests that abdominal visceral fat, rather than subcutaneous fat, is related to augmented sympathetic activity regardless of sex. Race/ethnicity may affect the relationship between obesity and sympathetic activity. Obesity-related hypertension has an important neurogenic component, which is characterized by sympathetic overactivity. However, sex may influence the association between hypertension and sympathetic overactivity in obese people. Finally, both body weight and sympathetic overactivity seem to be involved in the development of gestational hypertensive disorders in women. Chronic hyperinsulinemia due to insulin resistance, high plasma levels of leptin, and/or obstructive sleep apnea may be responsible for sympathetic overactivity in obesity-related hypertension.
KW - blood pressure
KW - body mass index
KW - gestational hypertensive disorders
KW - hypertension
KW - race
KW - the sympathetic nervous system
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U2 - 10.1111/nyas.14095
DO - 10.1111/nyas.14095
M3 - Review article
C2 - 31087350
AN - SCOPUS:85065776294
SN - 0077-8923
VL - 1454
SP - 31
EP - 41
JO - Annals of the New York Academy of Sciences
JF - Annals of the New York Academy of Sciences
IS - 1
ER -