Skip to content
2000
Volume 21, Issue 1
  • ISSN: 1573-4021
  • E-ISSN: 1875-6506

Abstract

A significant proportion of hypertensive patients are both smokers and obese. Several pathophysiological mechanisms are involved in the combined effect of smoking and obesity on hypertension onset and maintenance. These include increased sympathetic nervous system activity, endothelial dysfunction, inflammation, oxidative stress, and insulin resistance. The presence of these major cardiovascular risk factors may lead to difficult-to-control hypertension as well as substantially increase the risk for an adverse cardiovascular outcome. It is, therefore, imperative that healthcare providers embrace a comprehensive, multifaceted approach in the management of obese hypertensive patients with smoking habits. This review delves into the complex interplay of these risk factors, providing a comprehensive overview of the current literature to aid the deployment of effective clinical management strategies toward reducing the risk profile of affected individuals.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/chyr/10.2174/0115734021351026250126165154
2025-02-11
2025-11-05

  • From This Site

    /content/journals/chyr/10.2174/0115734021351026250126165154
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. MurrayC.J.L. AravkinA.Y. ZhengP. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: A systematic analysis for the Global burden of disease study 2019.Lancet2020396102581223124910.1016/S0140‑6736(20)30752‑2 33069327
     [Google Scholar]
  2. FlintA.C. ConellC. RenX. Effect of systolic and diastolic blood pressure on cardiovascular outcomes.N. Engl. J. Med.2019381324325110.1056/NEJMoa1803180 31314968
     [Google Scholar]
  3. Zubeldia LauzuricaL. Quiles IzquierdoJ. Mañes VinuesaJ. Redón MásJ. Prevalence of hypertension and associated factors in population aged 16 to 90 years old in Valencia region, Spain.Rev Esp Public Health201690E9 27032998
     [Google Scholar]
  4. RothG.A. HuffmanM.D. MoranA.E. Global and regional patterns in cardiovascular mortality from 1990 to 2013.Circulation2015132171667167810.1161/CIRCULATIONAHA.114.008720 26503749
     [Google Scholar]
  5. LauderL. MahfoudF. AziziM. Hypertension management in patients with cardiovascular comorbidities.Eur. Heart J.202344232066207710.1093/eurheartj/ehac395 36342266
     [Google Scholar]
  6. PoulterN. Global risk of cardiovascular disease.Heart2003892ii210.1136/heart.89.suppl_2.ii2
     [Google Scholar]
  7. TouloumiG. KarakostaA. KalpourtziN. High prevalence of cardiovascular risk factors in adults living in Greece: The EMENO National Health Examination Survey.BMC Public Health2020201166510.1186/s12889‑020‑09757‑4 33160307
     [Google Scholar]
  8. FreitasS.R.S. AlvimR.O. Smoking and blood pressure phenotypes: New perspective for an old problem.Am. J. Hypertens.201730655455510.1093/ajh/hpx039 28369308
     [Google Scholar]
  9. JohnU. MeyerC. HankeM. VölzkeH. SchumannA. Smoking status, obesity and hypertension in a general population sample: A cross-sectional study.QJM200699640741510.1093/qjmed/hcl047 16687420
     [Google Scholar]
  10. CohenJ.B. Hypertension in obesity and the impact of weight loss.Curr. Cardiol. Rep.201719109810.1007/s11886‑017‑0912‑4 28840500
     [Google Scholar]
  11. TeoK.K. OunpuuS. HawkenS. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: A case-control study.Lancet2006368953664765810.1016/S0140‑6736(06)69249‑0 16920470
     [Google Scholar]
  12. KotsisV. TsioufisK. AntzaC. Obesity and cardiovascular risk.J. Hypertens.20183671441145510.1097/HJH.0000000000001731 29652731
     [Google Scholar]
  13. ZhangY.B. PanX.F. ChenJ. Combined lifestyle factors, all-cause mortality and cardiovascular disease: A systematic review and meta-analysis of prospective cohort studies.J. Epidemiol. Community Health2021751929910.1136/jech‑2020‑214050 32892156
     [Google Scholar]
  14. WangX. QinL.Q. ArafaA. EshakE.S. HuY. DongJ.Y. Smoking cessation, weight gain, cardiovascular risk, and all-cause mortality: A meta-analysis.Nicotine Tob. Res.202123121987199410.1093/ntr/ntab076 33876246
     [Google Scholar]
  15. FreedmanD.M. SigurdsonA.J. RajaramanP. DoodyM.M. LinetM.S. RonE. The mortality risk of smoking and obesity combined.Am. J. Prev. Med.200631535536210.1016/j.amepre.2006.07.022 17046405
     [Google Scholar]
  16. AkbartabartooriM. LeanM.E.J. HankeyC.R. Smoking combined with overweight or obesity markedly elevates cardiovascular risk factors.Eur. J. Cardiovasc. Prev. Rehabil.200613693894610.1097/01.hjr.0000214613.29608.f5 17143126
     [Google Scholar]
  17. NiskanenL. LaaksonenD.E. NyyssönenK. Inflammation, abdominal obesity, and smoking as predictors of hypertension.Hypertension200444685986510.1161/01.HYP.0000146691.51307.84 15492131
     [Google Scholar]
  18. PeetersA. BarendregtJ.J. WillekensF. MackenbachJ.P. MamunA.A. BonneuxL. Obesity in adulthood and its consequences for life expectancy: A life-table analysis.Ann. Intern. Med.20031381243210.7326/0003‑4819‑138‑1‑200301070‑00008 12513041
     [Google Scholar]
  19. WilliamsB. ManciaG. SpieringW. 2018 ESC/ESH Guidelines for the management of arterial hypertension.J. Hypertens.201836101953204110.1097/HJH.0000000000001940 30234752
     [Google Scholar]
  20. BenincasaG. CoscioniE. NapoliC. Cardiovascular risk factors and molecular routes underlying endothelial dysfunction: Novel opportunities for primary prevention.Biochem. Pharmacol.202220211510810.1016/j.bcp.2022.115108 35643340
     [Google Scholar]
  21. BatatinhaH.A.P. Rosa NetoJ.C. KrügerK. Inflammatory features of obesity and smoke exposure and the immunologic effects of exercise.Exerc. Immunol. Rev.20192596111 30753132
     [Google Scholar]
  22. DimitriadisK. NarkiewiczK. LeontsinisI. Acute effects of electronic and tobacco cigarette smoking on sympathetic nerve activity and blood pressure in humans.Int. J. Environ. Res. Public Health2022196323710.3390/ijerph19063237 35328926
     [Google Scholar]
  23. da SilvaA.A. do CarmoJ. DubinionJ. HallJ.E. The role of the sympathetic nervous system in obesity-related hypertension.Curr. Hypertens. Rep.200911320621110.1007/s11906‑009‑0036‑3 19442330
     [Google Scholar]
  24. LermanA. ZeiherA.M. Endothelial function.Circulation2005111336336810.1161/01.CIR.0000153339.27064.14 15668353
     [Google Scholar]
  25. LugadeA.A. BognerP.N. ThatcherT.H. SimeP.J. PhippsR.P. ThanavalaY. Cigarette smoke exposure exacerbates lung inflammation and compromises immunity to bacterial infection.J. Immunol.2014192115226523510.4049/jimmunol.1302584 24752444
     [Google Scholar]
  26. HaassM. KüblerW. Nicotine and sympathetic neurotransmission.Cardiovasc. Drugs Ther.199710665766510.1007/BF00053022 9110108
     [Google Scholar]
  27. NajemB. HoussièreA. PathakA. Acute cardiovascular and sympathetic effects of nicotine replacement therapy.Hypertension20064761162116710.1161/01.HYP.0000219284.47970.34 16651463
     [Google Scholar]
  28. AlexopoulosN. KatritsisD. RaggiP. Visceral adipose tissue as a source of inflammation and promoter of atherosclerosis.Atherosclerosis2014233110411210.1016/j.atherosclerosis.2013.12.023 24529130
     [Google Scholar]
  29. WangH. ChenH. FuY. Effects of smoking on inflammatory-related cytokine levels in human serum.Molecules20222712371510.3390/molecules27123715 35744838
     [Google Scholar]
  30. XuL. KitadeH. NiY. OtaT. Roles of chemokines and chemokine receptors in obesity-associated insulin resistance and nonalcoholic fatty liver disease.Biomolecules2015531563157910.3390/biom5031563 26197341
     [Google Scholar]
  31. ChenH. HansenM.J. JonesJ.E. VlahosR. AndersonG.P. MorrisM.J. Detrimental metabolic effects of combining long-term cigarette smoke exposure and high-fat diet in mice.Am. J. Physiol. Endocrinol. Metab.20072936E1564E157110.1152/ajpendo.00442.2007 17940214
     [Google Scholar]
  32. TanniS.E. PelegrinoN.R.G. AngeleliA.Y.O. CorreaC. GodoyI. Smoking status and tumor necrosis factor-alpha mediated systemic inflammation in COPD patients.J. Inflamm. (Lond.)2010712910.1186/1476‑9255‑7‑29 20534161
     [Google Scholar]
  33. KacelE.L. KirschJ.L. SannesT.S. Interleukin-6 and body mass index, tobacco use, and sleep in gynecologic cancers.Health Psychol.2019381086687710.1037/hea0000775 31368718
     [Google Scholar]
  34. IkonomidisI. LekakisJ. VamvakouG. AndreottiF. NihoyannopoulosP. Cigarette smoking is associated with increased circulating proinflammatory and procoagulant markers in patients with chronic coronary artery disease.Am. Heart J.2005149583283910.1016/j.ahj.2004.08.030 15894964
     [Google Scholar]
  35. GhanbariM. MaraghehS.M. AghazadehA. Interleukin-1 in obesity-related low-grade inflammation: From molecular mechanisms to therapeutic strategies.Int. Immunopharmacol.20219610776510.1016/j.intimp.2021.107765 34015596
     [Google Scholar]
  36. JiangH. GuoZ. ZengK. IL-1β knockdown inhibits cigarette smoke extract-induced inflammation and apoptosis in vascular smooth muscle cells.PLoS One2023182e027771910.1371/journal.pone.0277719 36791122
     [Google Scholar]
  37. SzulińskaM. PiorunekT. SuliburskaJ. Evaluation of insulin resistance, tumor necrosis factor alpha, and total antioxidant status in obese patients smoking cigarettes.Eur. Rev. Med. Pharmacol. Sci.2013171419161922 23877857
     [Google Scholar]
  38. Lazar-PoloczekE. RomukE. JachećW. Levels of TNF-α and soluble TNF receptors in normal-weight, overweight and obese patients with dilated non-ischemic cardiomyopathy: Does anti-TNF therapy still have potential to be used in heart failure depending on BMI?Biomedicines20221011295910.3390/biomedicines10112959 36428528
     [Google Scholar]
  39. PierceG.L. LesniewskiL.A. LawsonB.R. BeskeS.D. SealsD.R. Nuclear factor-kappaB activation contributes to vascular endothelial dysfunction via oxidative stress in overweight/obese middle-aged and older humans.Circulation200911991284129210.1161/CIRCULATIONAHA.108.804294 19237660
     [Google Scholar]
  40. PamukcuB. LipG.Y.H. ShantsilaE. The nuclear factor – kappa B pathway in atherosclerosis: A potential therapeutic target for atherothrombotic vascular disease.Thromb. Res.2011128211712310.1016/j.thromres.2011.03.025 21636112
     [Google Scholar]
  41. SchramM.T. StamF. de JonghR.T. The effect of calcium dobesilate on vascular endothelial function, blood pressure, and markers of oxidation in obese male smokers: A placebo-controlled randomised clinical trial.Atherosclerosis20031701597210.1016/S0021‑9150(03)00231‑4 12957683
     [Google Scholar]
  42. de WintherM.P.J. KantersE. KraalG. HofkerM.H. Nuclear factor kappaB signaling in atherogenesis.Arterioscler. Thromb. Vasc. Biol.200525590491410.1161/01.ATV.0000160340.72641.87 15731497
     [Google Scholar]
  43. SugiuraT. DohiY. TakaseH. YamashitaS. FujiiS. OhteN. Oxidative stress is closely associated with increased arterial stiffness, especially in aged male smokers without previous cardiovascular events: A cross-sectional study.J. Atheroscler. Thromb.201724111186119810.5551/jat.39289 28674322
     [Google Scholar]
  44. ElluluM.S. PatimahI. Khaza’aiH. RahmatA. AbedY. Obesity and inflammation: The linking mechanism and the complications.Arch. Med. Sci.20174485186310.5114/aoms.2016.58928 28721154
     [Google Scholar]
  45. SilvaF.C. AraújoB.J. CordeiroC.S. Endothelial dysfunction due to the inhibition of the synthesis of nitric oxide: Proposal and characterization of an in vitro cellular model.Front. Physiol.20221397837810.3389/fphys.2022.978378 36467706
     [Google Scholar]
  46. DeLalioL.J. SvedA.F. StockerS.D. Sympathetic nervous system contributions to hypertension: Updates and therapeutic relevance.Can. J. Cardiol.202036571272010.1016/j.cjca.2020.03.003 32389344
     [Google Scholar]
  47. HeringD. SomersV.K. KaraT. Sympathetic neural responses to smoking are age dependent.J. Hypertens.200624469169510.1097/01.hjh.0000217851.95583.57 16531797
     [Google Scholar]
  48. TsioufisC. DimitriadisK. Sympathetic system–related artery stiffness.Hypertension201973597597610.1161/HYPERTENSIONAHA.119.12571 30905191
     [Google Scholar]
  49. KoumallosN. SigalaE. MilasT. Angiotensin regulation of vascular homeostasis: Exploring the role of ROS and RAS blockers.Int. J. Mol. Sci.202324151211110.3390/ijms241512111 37569484
     [Google Scholar]
  50. LopesH.F. Corrêa-GiannellaM.L. Consolim-ColomboF.M. EganB.M. Visceral adiposity syndrome.Diabetol. Metab. Syndr.2016814010.1186/s13098‑016‑0156‑2 27437032
     [Google Scholar]
  51. ZhuB. ParmleyW.W. Hemodynamic and vascular effects of active and passive smoking.Am. Heart J.199513061270127510.1016/0002‑8703(95)90154‑X 7484781
     [Google Scholar]
  52. SeravalleG. GrassiG. Obesity and hypertension.Pharmacol. Res.20171221710.1016/j.phrs.2017.05.013 28532816
     [Google Scholar]
  53. HanssonP.O. ErikssonH. WelinL. SvärdsuddK. WilhelmsenL. Smoking and abdominal obesity: Risk factors for venous thromboembolism among middle-aged men: “The study of men born in 1913”.Arch. Intern. Med.1999159161886189010.1001/archinte.159.16.1886 10493318
     [Google Scholar]
  54. MessnerB. BernhardD. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis.Arterioscler. Thromb. Vasc. Biol.201434350951510.1161/ATVBAHA.113.300156 24554606
     [Google Scholar]
  55. BlokhinI.O. LentzS.R. Mechanisms of thrombosis in obesity.Curr. Opin. Hematol.201320543744410.1097/MOH.0b013e3283634443 23817170
     [Google Scholar]
  56. DickerD. FeldmanB.S. Leventer-RobertsM. BenisA. Obesity or smoking: Which factor contributes more to the incidence of myocardial infarction?Eur. J. Intern. Med.201632434610.1016/j.ejim.2016.03.029 27151319
     [Google Scholar]
  57. YaoF. LiuW. ZhaoR. LiG. HuangX. ChenY. BMI modified the association of current smoking with the incidence of hypertension in Chinese population: A 22-year cohort study.BMC Public Health202020129510.1186/s12889‑020‑8428‑z 32138723
     [Google Scholar]
  58. SaiX.Y. GaoF. ZhangW.Y. Combined effect of smoking and obesity on coronary heart disease mortality in male veterans: A 30-year cohort study.Biomed. Environ. Sci.202134318419110.3967/bes2021.012 33766214
     [Google Scholar]
  59. LuijckxE. LohseT. FaehD. RohrmannS. Joints effects of BMI and smoking on mortality of all-causes, CVD, and cancer.Cancer Causes Control201930554955710.1007/s10552‑019‑01160‑8 30911976
     [Google Scholar]
  60. BonaccioM. Di CastelnuovoA. CostanzoS. Impact of combined healthy lifestyle factors on survival in an adult general population and in high‐risk groups: Prospective results from the Moli‐sani Study.J. Intern. Med.2019286220722010.1111/joim.12907 30993789
     [Google Scholar]
  61. HjellvikV. SelmerR. GjessingH.K. TverdalA. VollsetS.E. Body mass index, smoking, and risk of death between 40 and 70 years of age in a Norwegian cohort of 32,727 women and 33,475 men.Eur. J. Epidemiol.2013281354310.1007/s10654‑012‑9758‑7 23338903
     [Google Scholar]
  62. MaJ. JemalA. FlandersW.D. WardE.M. Joint association of adiposity and smoking with mortality among U.S. adults.Prev. Med.2013563-417818410.1016/j.ypmed.2012.12.012 23276778
     [Google Scholar]
  63. O’DonnellC.J. ElosuaR. Cardiovascular risk factors. Insights from Framingham heart study.Rev. Esp. Cardiol.200861329931010.1157/13116658 18361904
     [Google Scholar]
  64. YusufS. HawkenS. ÔunpuuS. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study.Lancet2004364943893795210.1016/S0140‑6736(04)17018‑9 15364185
     [Google Scholar]
  65. LohseT. RohrmannS. BoppM. FaehD. Heavy smoking is more strongly associated with general unhealthy lifestyle than obesity and underweight.PLoS One2016112e014856310.1371/journal.pone.0148563 26910775
     [Google Scholar]
  66. KosterA. LeitzmannM.F. SchatzkinA. The combined relations of adiposity and smoking on mortality.Am. J. Clin. Nutr.20088851206121210.3945/ajcn.2008.26298 18996854
     [Google Scholar]
  67. PapathanasiouG. ZervaE. ZacharisI. Association of high blood pressure with body mass index, smoking and physical activity in healthy young adults.Open Cardiovasc. Med. J.20159151710.2174/1874192401509010005 25834651
     [Google Scholar]
  68. de GonzalezA.B. HartgeP. CerhanJ.R. Body-mass index and mortality among 1.46 million white adults.N. Engl. J. Med.2010363232211221910.1056/NEJMoa1000367 21121834
     [Google Scholar]
  69. HuY. ZongG. LiuG. Smoking cessation, weight change, type 2 diabetes, and mortality.N. Engl. J. Med.2018379762363210.1056/NEJMoa1803626 30110591
     [Google Scholar]
  70. ManciaG. KreutzR. BrunströmM. ESH Guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH).J. Hypertens.202341121874207110.1097/HJH.0000000000003480
     [Google Scholar]
  71. Locken-CastillaA. Pacheco-PantojaE.L. Rodríguez-BritoF. May-KimS. López-RivasV. Ceballos-CruzA. Smoking index, lifestyle factors, and genomic instability assessed by single-cell gel electrophoresis: A cross-sectional study in subjects from Yucatan, Mexico.Clin. Epigenetics201911115010.1186/s13148‑019‑0745‑7 31665072
     [Google Scholar]
  72. WangQ. SongX. DuS. Waist circumference trajectories in relation to blood pressure and the risk of hypertension in chinese adults.Nutrients20221424526010.3390/nu14245260 36558419
     [Google Scholar]
  73. VisserenF.L.J. MachF. SmuldersY.M. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.Eur. Heart J.202142343227333710.1093/eurheartj/ehab484 34458905
     [Google Scholar]
  74. YuristaS. EderR. FeeleyM. A closer look at ACC/AHA and ESC guidelines for managing obesity and overweight in adults.JACC Adv.20232710057010.1016/j.jacadv.2023.100570
     [Google Scholar]
  75. ArnettD.K. BlumenthalR.S. AlbertM.A. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the american college of cardiology/american heart association task force on clinical practice guidelines.Circulation201914011e596e64610.1161/CIR.0000000000000678 30879355
     [Google Scholar]
  76. BushT. LovejoyJ.C. DepreyM. CarpenterK.M. The effect of tobacco cessation on weight gain, obesity, and diabetes risk.Obesity (Silver Spring)20162491834184110.1002/oby.21582 27569117
     [Google Scholar]
  77. HubbardR. LewisS. SmithC. Use of nicotine replacement therapy and the risk of acute myocardial infarction, stroke, and death.Tob. Control200514641642110.1136/tc.2005.011387 16319366
     [Google Scholar]
  78. ParikhN.S. Salehi OmranS. KamelH. ElkindM.S.V. WilleyJ.Z. Smoking-cessation pharmacotherapy for patients with stroke and TIA: Systematic review.J. Clin. Neurosci.20207823624110.1016/j.jocn.2020.04.026 32334957
     [Google Scholar]
  79. MockingR.J.T. PflanzC.P. PringleA. Effects of short-term varenicline administration on emotional and cognitive processing in healthy, non-smoking adults: A randomized, double-blind, study.Neuropsychopharmacology201338347648410.1038/npp.2012.205 23072834
     [Google Scholar]
  80. Harrison-WoolrychM. Mental health effects of varenicline.BMJ2015350mar17 5h116810.1136/bmj.h1168 25784713
     [Google Scholar]
  81. MeyerJ. RohrmannS. BoppM. FaehD. GroupS.N.C.S. Impact of smoking and excess body weight on overall and site-specific cancer mortality risk.Cancer Epidemiol. Biomarkers Prev.201524101516152210.1158/1055‑9965.EPI‑15‑0415 26215293
     [Google Scholar]
  82. AveyardP. BeghR. ParsonsA. WestR. Brief opportunistic smoking cessation interventions: A systematic review and meta‐analysis to compare advice to quit and offer of assistance.Addiction201210761066107310.1111/j.1360‑0443.2011.03770.x 22175545
     [Google Scholar]
  83. NdumeleC.E. RangaswamiJ. ChowS.L. Cardiovascular-kidney-metabolic health: A presidential advisory from the american heart association.Circulation2023148201606163510.1161/CIR.0000000000001184 37807924
     [Google Scholar]
  84. MartinJ.C. AwokeM.A. MissoM.L. MoranL.J. HarrisonC.L. Preventing weight gain in adults: A systematic review and meta‐analysis of randomized controlled trials.Obes. Rev.20212210e1328010.1111/obr.13280 34028958
     [Google Scholar]
  85. LavieC.J. LadduD. ArenaR. OrtegaF.B. AlpertM.A. KushnerR.F. Healthy weight and obesity prevention.J. Am. Coll. Cardiol.201872131506153110.1016/j.jacc.2018.08.1037 30236314
     [Google Scholar]
  86. NooneC. LeahyJ. MorrisseyE.C. Comparative efficacy of exercise and anti-hypertensive pharmacological interventions in reducing blood pressure in people with hypertension: A network meta-analysis.Eur. J. Prev. Cardiol.202027324725510.1177/2047487319879786 31615283
     [Google Scholar]
  87. OzemekC. PhillipsS.A. PopovicD. Nonpharmacologic management of hypertension.Curr. Opin. Cardiol.201732438138810.1097/HCO.0000000000000406 28319484
     [Google Scholar]
  88. HallM.E. CohenJ.B. ArdJ.D. Weight-loss strategies for prevention and treatment of hypertension: A scientific statement from the American heart association.Hypertension2021785e38e5010.1161/HYP.0000000000000202 34538096
     [Google Scholar]
  89. BianchettinR.G. LavieC.J. Lopez-JimenezF. Challenges in cardiovascular evaluation and management of obese patients.J. Am. Coll. Cardiol.202381549050410.1016/j.jacc.2022.11.031 36725178
     [Google Scholar]
  90. Van HornL. CarsonJ.A.S. AppelL.J. Recommended dietary pattern to achieve adherence to the american heart association/american college of cardiology (aha/acc) guidelines: A scientific statement from the American heart association.Circulation201613422e505e52910.1161/CIR.0000000000000462 27789558
     [Google Scholar]
  91. KaranjaN.M. ObarzanekE. LinP.H. Descriptive characteristics of the dietary patterns used in the dietary approaches to stop hypertension trial.J. Am. Diet. Assoc.1999998Suppl.S19S2710.1016/S0002‑8223(99)00412‑5 10450290
     [Google Scholar]
  92. Bach-FaigA. BerryE.M. LaironD. Mediterranean diet pyramid today. Science and cultural updates.Public Health Nutr.20111412A2274228410.1017/S1368980011002515 22166184
     [Google Scholar]
  93. FilippouC.D. ThomopoulosC.G. KouremetiM.M. Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled trials.Clin. Nutr.20214053191320010.1016/j.clnu.2021.01.030 33581952
     [Google Scholar]
  94. FilippiniT. MalavoltiM. WheltonP.K. NaskaA. OrsiniN. VincetiM. Blood pressure effects of sodium reduction.Circulation2021143161542156710.1161/CIRCULATIONAHA.120.050371 33586450
     [Google Scholar]
  95. FilippouC. ThomopoulosC. KonstantinidisD. DASH vs. Mediterranean diet on a salt restriction background in adults with high normal blood pressure or grade 1 hypertension: A randomized controlled trial.Clin. Nutr.202342101807181610.1016/j.clnu.2023.08.011 37625311
     [Google Scholar]
  96. GanesanK. HabboushY. SultanS. Intermittent fasting: The choice for a healthier lifestyle.Cureus2018107e294710.7759/cureus.2947 30202677
     [Google Scholar]
  97. JensenM.D. RyanD.H. ApovianC.M. 2013 AHA/ACC/TOS Guideline for the management of overweight and obesity in adults.J. Am. Coll. Cardiol.2014632525 Pt B2985302310.1016/j.jacc.2013.11.004 24239920
     [Google Scholar]
  98. CohenJ.B. GaddeK.M. Weight loss medications in the treatment of obesity and hypertension.Curr. Hypertens. Rep.20192121610.1007/s11906‑019‑0915‑1 30747357
     [Google Scholar]
  99. KlausenM.K. ThomsenM. WortweinG. Fink-JensenA. The role of glucagon‐like peptide 1 (GLP‐1) in addictive disorders.Br. J. Pharmacol.2022179462564110.1111/bph.15677 34532853
     [Google Scholar]
  100. LincoffA.M. Brown-FrandsenK. ColhounH.M. Semaglutide and cardiovascular outcomes in obesity without diabetes.N. Engl. J. Med.2023389242221223210.1056/NEJMoa2307563 37952131
     [Google Scholar]
  101. MechanickJ.I. YoudimA. JonesD.B. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery.Obesity (Silver Spring)2013211s1s2710.1002/oby.20461
     [Google Scholar]
  102. SchiavonC.A. Bersch-FerreiraA.C. SantucciE.V. Effects of Bariatric surgery in obese patients with hypertension.Circulation2018137111132114210.1161/CIRCULATIONAHA.117.032130 29133606
     [Google Scholar]
/content/journals/chyr/10.2174/0115734021351026250126165154
Loading
The Combined Effect of Smoking and Obesity on Hypertension: Implications for Clinical Management
Current Hypertension Reviews 21, 2 (2025); https://doi.org/10.2174/0115734021351026250126165154
/content/journals/chyr/10.2174/0115734021351026250126165154
/content/journals/chyr/10.2174/0115734021351026250126165154
Loading

Data & Media loading...


  • Article Type:     Review Article
Keyword(s): combined effect; Hypertension; obesity; oxidative stress; smoking; tobacco

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test