ABSTRACT
Adipose tissue production of adipokines and cytokines, neurohumoral pathways and metabolic functions contribute to mechanisms that cause hypertension. Obesity-related hypertension may be the result of a combination or overlap of a number of these factors. The diabetic patient should have orthostatic blood pressure measured, as the coexistence of diabetic neuropathy may exaggerate orthostatic hypotension. Diagnosis of hypertension should be done with the correct cuff size because of the increased circumference of the obese subject's arm. Obesity increases blood volume and cardiac output, leading to excess venous return to heart. Obesity-induced hypertension may also in part explain the development of left ventricle hypertrophy. Diabetes mellitus and hypertension are independent factors for chronic kidney disease. Lifestyle interventions constitute behavioural modifications and hypocaloric diets. Behavioural therapy is based on self-monitoring of food intake, increased physical activity, stimulus control, problem solving and relapse prevention.
