Hypertension, obesity, and the renin-angiotensin system: a tale of tight associations.

Obesity, hypertension, and their co-morbid conditions such as diabetes mellitus and cardiovascular disease are major public health issues. This article reviews research that links hypertension and obesity, particularly the android obesity pattern that characterizes the metabolic syndrome. The article focuses on the relationships between hypertension, obesity, and the renin-angiotensin system (RAS). It explores new understandings about the RAS and the connections between RAS overactivity, hypertension, and obesity. Also discussed are lines of evidence that show that elevated visceral fat levels contribute to renin-angiotensin overactivity and that RAS overactivity contributes to the development of obesity. The bidirectional nature of the obesity-RAS relationship is discussed.