Adiponectin, Cardiovascular Function, and Hypertension

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Hypertension is a major risk factor for cardiovascular disease, and the latter is the leading cause of morbidity and mortality worldwide. In developed countries, hypertension ranks as the top contributing factor for mortality and third in causing disability-adjusted life years.1 Hypertension is a polygenic and complex disease with rising prevalence. More than 25% of the adult population is affected by hypertension, and two thirds of those individuals reside in developing countries.2 Europe shows an even higher prevalence of hypertension than North America.3 With the present trends, the prevalence of hypertension is predicted to increase to 30%, or ≈1.5 billion people, on the globe in the next 20 years.2 Mechanistically, endothelial dysfunction, increased renin-angiotensin system (RAS) activity, and sympathetic nervous system (SNS) hyperactivation have been considered as important risk factors of hypertension and hint at important events taking place at the interface of the endothelium, kidney, and SNS. Obesity is a global epidemic in children and adults. In the United States, a steady increase of the prevalence of obesity has been found in all states.4,5 It is estimated that 65% of the population is overweight, which is judged by body mass index of 25.0 to 29.9, and 30% are obese (body mass index of ≥30.0).6 These numbers have been continuously rising in the past 15 years.7 The National Health and Nutrition Examination Survey III for ≈18 000 adults found that body mass index is an associated risk factor for hypertension independent of age, sex, race, and smoking.8 A long-term weight/hypertension relationship study showed that weight loss of ≈10 kg is associated with a significant decrease of both diastolic and systolic blood pressure.9 Obesity and hypertension are 2 complex disorders that are closely interrelated, but the precise underlying association remains elusive. The uncontrolled …