Saturday, April 04, 2015

A new proposed mechanism for how obesity drives hypertension and other cardiovascular complications: the lowered natriuretic peptide setpoint

It's been known for quite a while that BNP and proBNP levels tend to be low in obese patients, even in heart failure. It is also well known that the natriuretic peptides help maintain sodium balance by facilitating excretion in response to a sodium load and that their activities are antagonistic to the renin angiotensin system.

This all leads to the notion that reduced BNP is a mechanism by which obesity drives hypertension and other cardiovascular events. In an elegant piece of clinical research investigators at Vanderbilt University marshaled evidence in support of that mechanism and also demonstrated reversal of the abnormal BNP setpoint after weight loss surgery.

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